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HEATHER CANTRELL C.N.M.
>> Midwife >> Other Service ProvidersRegistrant NPI Number: 1255354114
Individual Registrant: HEATHER CANTRELL C.N.M.
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
190 HANDLEY RD TYRONE, GA 30290-2178 US
Tel: 770-997-5714 Fax: 770-997-2810
Tel: 770-997-5714 Fax: 770-997-2810
Contact information for business:
190 HANDLEY RD TYRONE, GA 30290-2178 US
Tel: 770-997-5714 Fax: 770-997-2810
Tel: 770-997-5714 Fax: 770-997-2810
Registration Information:
NPI: 1255354114
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 176B00000X | Other Service Providers Midwife | GA | RN144694 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 092104688A | GA | 05 |
