Provider Demographics
NPI:1821358268
Name:HARRIS, HEATHER SUE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:SUE
Last Name:HARRIS
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 1:3651 DAWSON FOREST RD E
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534-0404
Mailing Address - Country:US
Mailing Address - Phone:706-216-7337
Mailing Address - Fax:
Practice Address - Street 1:3651 DAWSON FOREST RD E
Practice Address - Street 2:SUITE 100
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-0404
Practice Address - Country:US
Practice Address - Phone:706-216-7337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN177469363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily