Provider Demographics
NPI:1649504457
Name:NOBLETT, HEATHER DAWN (NP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:DAWN
Last Name:NOBLETT
Suffix:
Gender:F
Credentials:NP
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Other - First Name:
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Mailing Address - Street 1:748 OLD NORCROSS RD
Mailing Address - Street 2:SUITE 185
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-3393
Mailing Address - Country:US
Mailing Address - Phone:770-277-8554
Mailing Address - Fax:770-277-1799
Practice Address - Street 1:748 OLD NORCROSS RD
Practice Address - Street 2:SUITE 185
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-3393
Practice Address - Country:US
Practice Address - Phone:770-277-8554
Practice Address - Fax:770-277-1799
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-25
Last Update Date:2009-09-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA144708363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner