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General NPI Number Information
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NPI Number | 1033241476
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Entity Type | Individual
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Provider Name | EDNA JANE HEATH PHD
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Gender | Female
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 987 ST SEBASTIAN WAY - EC4350
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City | AUGUSTA
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State | GA
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Zip | 30912
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Country | US
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Telephone | 706-721-0422
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Fax |
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Provider Business Mailing Address
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Address Line | 3517 STEVENS WAY
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City | MARTINEZ
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State | GA
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Zip | 30907-9564
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Country | US
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Telephone | 706-210-7425
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | RN131105
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License Number State | GA
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