Champion, Heather M

Champion, Heather M is an individual health care provider with primary practice located at 3131 S Main St , Moultrie GA 31768-6925. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Champion, Heather M can be contacted via phone (229) 502-9782.

Contact Information

Primary practice address
3131 S Main St Moultrie GA 31768-6925
Phone: (229) 502-9782
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN195224 Georgia

Profile Details

NPI number 1356682447
LBN Legal business name Champion, Heather M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2013
Last updated Jul 28th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356682447 NPPES
Georgia MEDICAID 003133074D
Georgia Other RN195224

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