Provider Demographics
NPI:1447423165
Name:ALLEN, HEATHER T (CRNA, APRN)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:T
Last Name:ALLEN
Suffix:
Gender:F
Credentials:CRNA, APRN
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:E
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA, APRN
Mailing Address - Street 1:1364 CLIFTON RD NE
Mailing Address - Street 2:DEPARTMENT OF ANESTHESIOLOGY RM B349A
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-1059
Mailing Address - Country:US
Mailing Address - Phone:404-778-3900
Mailing Address - Fax:
Practice Address - Street 1:1405 CLIFTON RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1060
Practice Address - Country:US
Practice Address - Phone:404-778-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-03
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003756367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered