Provider Demographics
NPI:1750390399
Name:GARRETT, HEATHER ANNE (FNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANNE
Last Name:GARRETT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:ANNE
Other - Last Name:GRAHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 506
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:TN
Mailing Address - Zip Code:38344-0506
Mailing Address - Country:US
Mailing Address - Phone:731-535-3600
Mailing Address - Fax:731-535-3603
Practice Address - Street 1:126 W PARIS ST
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:TN
Practice Address - Zip Code:38344-3608
Practice Address - Country:US
Practice Address - Phone:731-535-3600
Practice Address - Fax:731-535-3603
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10524363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3468681Medicaid
TNQ071950Medicaid