Provider Demographics
NPI:1891319745
Name:FESPERMAN, HEATHER NICHOLE (PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:NICHOLE
Last Name:FESPERMAN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7556 US HIGHWAY 70
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38133-2686
Mailing Address - Country:US
Mailing Address - Phone:901-552-3497
Mailing Address - Fax:574-635-9228
Practice Address - Street 1:7556 US HIGHWAY 70
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38133-2686
Practice Address - Country:US
Practice Address - Phone:901-552-3497
Practice Address - Fax:574-635-9228
Is Sole Proprietor?:No
Enumeration Date:2020-06-05
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27136363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health