Healthcare Provider Details

I. General information

NPI: 1346096500
Provider Name (Legal Business Name): CAITLIN HEATH MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2024
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date: 06/05/2024
Reactivation Date: 10/07/2024

III. Provider practice location address

50 GLENLAKE PKWY STE 420
SANDY SPRINGS GA
30328-3489
US

IV. Provider business mailing address

50 GLENLAKE PKWY STE 420
SANDY SPRINGS GA
30328-3489
US

V. Phone/Fax

Practice location:
  • Phone: 404-941-1201
  • Fax: 770-273-4284
Mailing address:
  • Phone: 404-941-1201
  • Fax: 770-273-4284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN296944
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: