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General NPI Number Information
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NPI Number | 1598567877
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Entity Type | Individual
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Provider Name | KRISTEN ROACH HEUERMAN APRN, CNM
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Gender | Female
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Dates
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Enumeration Date | 03/26/2025
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 1942 ATKINSON RD STE 100
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-5004
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Country | US
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Telephone | 678-775-0600
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Fax | 678-377-5284
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Provider Business Mailing Address
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Address Line | 1942 ATKINSON RD STE 100
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-5004
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Country | US
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Telephone | 678-775-0600
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Fax | 678-377-5284
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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 | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | RN302045
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | RN302045
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License Number State | GA
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