Provider Demographics
NPI:1497102776
Name:HEILMAN, HANNAH (NP)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:HEILMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:DAVIS LANGLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:227 SCENIC HWY STE A
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-5649
Mailing Address - Country:US
Mailing Address - Phone:770-513-7666
Mailing Address - Fax:770-513-1093
Practice Address - Street 1:227 SCENIC HWY STE A
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-5649
Practice Address - Country:US
Practice Address - Phone:770-513-7666
Practice Address - Fax:770-513-1093
Is Sole Proprietor?:No
Enumeration Date:2016-05-17
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN204248363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1497102776Medicaid