Provider Demographics
NPI:1881963122
Name:QUAILE, HEATHER CALHOUN (NP-C)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:CALHOUN
Last Name:QUAILE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 WILD IRIS LN
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-6282
Mailing Address - Country:US
Mailing Address - Phone:757-470-4863
Mailing Address - Fax:
Practice Address - Street 1:3233 S CHEROKEE LN BLDG 1000
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-4461
Practice Address - Country:US
Practice Address - Phone:678-673-3953
Practice Address - Fax:678-487-3953
Is Sole Proprietor?:No
Enumeration Date:2011-12-15
Last Update Date:2020-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN234874363LX0001X
VA0024166294363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology