Provider Demographics
NPI:1861014425
Name:HERRIN, HEATHER SUMNER (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:SUMNER
Last Name:HERRIN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 MCCALL BLVD
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30461-4919
Mailing Address - Country:US
Mailing Address - Phone:912-508-2600
Mailing Address - Fax:
Practice Address - Street 1:3024 MCCALL BLVD
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30461-4919
Practice Address - Country:US
Practice Address - Phone:912-508-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-17
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN244866363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily