Individual
JENNIFER ASHLEY HEAVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
775 POPLAR RD, SUITE 150, NEWNAN, GA 30265-8300
(678) 633-3333
(678) 633-3334
Mailing address
PO BOX 102321, ATLANTA, GA 30368-2321
(770) 801-2386
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN180320
GA
Other
Enumeration date
06/28/2011
Last updated
08/13/2012
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