Provider Demographics
NPI:1780289595
Name:TEJEDA, HEATHER HEARN (FNP-C)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:HEARN
Last Name:TEJEDA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:HEATHER
Other - Middle Name:HEARN
Other - Last Name:DENHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:343 PLANTATION WAY
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-9286
Mailing Address - Country:US
Mailing Address - Phone:912-414-9963
Mailing Address - Fax:
Practice Address - Street 1:343 PLANTATION WAY
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-9286
Practice Address - Country:US
Practice Address - Phone:912-414-9963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-01
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN204837363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily