Individual
HEATHER BOHANNON-IYAMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
35 COLLIER RD NW STE 775, ATLANTA, GA 30309-1608
(404) 351-5959
Mailing address
35 COLLIER RD NW STE 775, ATLANTA, GA 30309-1608
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
GAA-NP002236
GA
363L00000X
Nurse Practitioner
19097
TN
363L00000X
Nurse Practitioner
Primary
GAA-NP002236
GA
363LF0000X
Family Nurse Practitioner
19097
TN
Other
Enumeration date
10/09/2014
Last updated
01/23/2025
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