Provider Demographics
NPI:1588797195
Name:HEABERG, GAIL LANTERMAN (APRN, FNP-C, DRPH)
Entity Type:Individual
Prefix:DR
First Name:GAIL
Middle Name:LANTERMAN
Last Name:HEABERG
Suffix:
Gender:F
Credentials:APRN, FNP-C, DRPH
Other - Prefix:MS
Other - First Name:GAIL
Other - Middle Name:ANN
Other - Last Name:LANTERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, FNP-C
Mailing Address - Street 1:105 SCARLETT DR
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-2517
Mailing Address - Country:US
Mailing Address - Phone:478-988-7872
Mailing Address - Fax:
Practice Address - Street 1:105 SCARLETT DR
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-2517
Practice Address - Country:US
Practice Address - Phone:478-988-7872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN165358363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily