Individual
HEATHER PEAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-5671
(770) 241-5235
(678) 682-8747
Mailing address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-5671
(770) 241-5235
(678) 682-8747
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN119363
GA
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
RN119363
GA
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN119363
GA
251J00000X
Nursing Care Agency
RN119363
GA
251S00000X
Community/Behavioral Health Agency
RN119363
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
N/A
—
GA
Enumeration date
01/27/2014
Last updated
01/27/2014
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