Healthcare Provider Details

I. General information

NPI: 1598572125
Provider Name (Legal Business Name): HONEYE HEYDARI FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2024
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5291 AIRLINE RD STE 108
ARLINGTON TN
38002-4274
US

IV. Provider business mailing address

5291 AIRLINE RD STE 108
ARLINGTON TN
38002-4274
US

V. Phone/Fax

Practice location:
  • Phone: 901-687-9878
  • Fax: 800-285-9818
Mailing address:
  • Phone: 901-687-9878
  • Fax: 800-285-9818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN35019
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: