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General NPI Number Information
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NPI Number | 1760253280
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Entity Type | Individual
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Provider Name | HEATHER DOCKERY PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/12/2024
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 1875 FANT DR
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City | FORT OGLETHORPE
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State | GA
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Zip | 30742-3300
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Country | US
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Telephone | 912-314-7563
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Fax | 912-216-3525
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Provider Business Mailing Address
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Address Line | 219 WATERS CEMETERY RD
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City | STATESBORO
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State | GA
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Zip | 30458-3691
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Country | US
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Telephone |
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Fax | 912-216-3525
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN325747
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License Number State | GA
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