Healthcare Provider Details

I. General information

NPI: 1760396758
Provider Name (Legal Business Name): HEATHER LYNN HUFNAGEL HOLDEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5445 MERIDIAN MARK RD STE 380
SANDY SPRINGS GA
30342-4755
US

IV. Provider business mailing address

5445 MERIDIAN MARK RD STE 380
SANDY SPRINGS GA
30342-4755
US

V. Phone/Fax

Practice location:
  • Phone: 404-705-3100
  • Fax: 404-705-3040
Mailing address:
  • Phone: 404-705-3100
  • Fax: 404-705-3040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN295344
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: