Provider Demographics
NPI:1437474434
Name:WILLIAMS, HEATHER TRUDEAU (FNP)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:TRUDEAU
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:TN
Mailing Address - Zip Code:37058-3352
Mailing Address - Country:US
Mailing Address - Phone:931-232-5555
Mailing Address - Fax:931-232-5514
Practice Address - Street 1:1225 SPRING ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:TN
Practice Address - Zip Code:37058-3352
Practice Address - Country:US
Practice Address - Phone:931-232-5555
Practice Address - Fax:931-232-5514
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-01
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14905363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner