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General NPI Number Information
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NPI Number | 1285515536
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Entity Type | Individual
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Provider Name | HEATHER ADCOCK NP
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Gender | Female
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Dates
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Enumeration Date | 09/11/2025
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1105 BURLEYSON RD
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City | DALTON
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State | GA
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Zip | 30720-3181
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Country | US
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Telephone | 423-664-4460
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Fax |
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Provider Business Mailing Address
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Address Line | 3700 SUGAR VALLEY RD NW
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City | SUGAR VALLEY
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State | GA
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Zip | 30746-5026
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Country | US
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Telephone | 706-271-5374
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | RN175981
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License Number State | GA
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