Provider Demographics
NPI:1619336005
Name:PICKELSIMER, HEATHER NICOLE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:NICOLE
Last Name:PICKELSIMER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:NICOLE
Other - Last Name:HARVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:528 PANTHER DR
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:GA
Mailing Address - Zip Code:30549-5400
Mailing Address - Country:US
Mailing Address - Phone:706-387-5655
Mailing Address - Fax:706-387-5554
Practice Address - Street 1:528 PANTHER DR
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:GA
Practice Address - Zip Code:30549
Practice Address - Country:US
Practice Address - Phone:706-387-5655
Practice Address - Fax:706-387-5554
Is Sole Proprietor?:No
Enumeration Date:2016-02-15
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA205932363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily