Provider Demographics
NPI:1720479009
Name:SWIHART, HEATHER ANDREA (CRNA, APRN)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANDREA
Last Name:SWIHART
Suffix:
Gender:F
Credentials:CRNA, APRN
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:BRANDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:118 MILL STREET
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188
Mailing Address - Country:US
Mailing Address - Phone:678-741-2317
Mailing Address - Fax:912-350-7036
Practice Address - Street 1:118 MILL STREET
Practice Address - Street 2:SUITE 110
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188
Practice Address - Country:US
Practice Address - Phone:678-741-2317
Practice Address - Fax:912-350-7036
Is Sole Proprietor?:No
Enumeration Date:2015-02-09
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCCRNA197203367500000X
GARN245528367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered