Coburn, Heather L

Coburn, Heather L is an individual health care provider with primary practice located at 1019 W Oakland Ave Suite 1, Johnson City TN 37604. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Coburn, Heather L can be contacted via phone (423) 915-5000.

Contact Information

Primary practice address
1019 W Oakland Ave Suite 1 Johnson City TN 37604
Phone: (423) 915-5000
Fax: (423) 915-5045
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA01205 Tennessee

Profile Details

NPI number 1932165545
LBN Legal business name Coburn, Heather L
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 22nd, 2006
Last updated Jun 4th, 2018 - about 6 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 1932165545 NPPES
Virginia MEDICAID 1932165545
Virginia MEDICAID Q003283

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