Individual
MRS. HEATHER G DISMUKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
101 COBBLESTONE TRCE SE, MOULTRIE, GA 31788-7747
(229) 891-9016
(229) 891-9185
Mailing address
PO BOX 2876, MOULTRIE, GA 31776-2876
(229) 891-9016
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN293813
GA
Other
Enumeration date
06/22/2023
Last updated
09/04/2025
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