Provider Demographics
NPI:1477196053
Name:PAQUETTE, HEIDI RENAY (FNP-C)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:RENAY
Last Name:PAQUETTE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15849
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31416-2549
Mailing Address - Country:US
Mailing Address - Phone:912-303-3552
Mailing Address - Fax:912-303-3506
Practice Address - Street 1:1326 EISENHOWER DR BLDG 1
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3928
Practice Address - Country:US
Practice Address - Phone:912-527-5225
Practice Address - Fax:912-303-3506
Is Sole Proprietor?:No
Enumeration Date:2019-10-25
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN205277163W00000X, 363LF0000X
TNAPN0000029399363L00000X
COC-APN.0001626-C-NP363LF0000X
GARN205277NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily