Provider Demographics
NPI:1962691287
Name:BURLESON, HEATHER DANEEN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:DANEEN
Last Name:BURLESON
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:174 SAUNDERSVILLE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-8964
Mailing Address - Country:US
Mailing Address - Phone:615-600-4811
Mailing Address - Fax:615-970-7651
Practice Address - Street 1:174 SAUNDERSVILLE RD STE 103
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-8964
Practice Address - Country:US
Practice Address - Phone:615-600-4811
Practice Address - Fax:615-970-7651
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2024-09-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNPA3600207QB0002X, 363AM0700X
FLPA9104308363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity Medicine
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant