Healthcare Provider Details

I. General information

NPI: 1669170643
Provider Name (Legal Business Name): HEATHER STREICHERT FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2023
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2412 N OAK ST
VALDOSTA GA
31602-2567
US

IV. Provider business mailing address

2412 N OAK ST
VALDOSTA GA
31602-2567
US

V. Phone/Fax

Practice location:
  • Phone: 229-244-1400
  • Fax: 229-244-5512
Mailing address:
  • Phone: 229-244-1400
  • Fax: 229-244-5512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN278197
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: