Provider Demographics
NPI:1417130626
Name:OLIVAS, HEATHER M (APRN,BC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:M
Last Name:OLIVAS
Suffix:
Gender:F
Credentials:APRN,BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2931 BERRY HILL DR
Mailing Address - Street 2:STE 100
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-3136
Mailing Address - Country:US
Mailing Address - Phone:615-614-5880
Mailing Address - Fax:615-614-5884
Practice Address - Street 1:2931 BERRY HILL DR
Practice Address - Street 2:STE 100
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-3136
Practice Address - Country:US
Practice Address - Phone:615-678-7028
Practice Address - Fax:615-678-7085
Is Sole Proprietor?:No
Enumeration Date:2007-12-11
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN13054364SF0001X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2007008422-22OtherBOARD CERTIFICATION