Individual
MISS HEIDI FORTE BISHOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1041 NOELL LN, SUITE 105, ROCKY MOUNT, NC 27804-2058
(252) 451-2700
(252) 451-2702
Mailing address
PO BOX 1335, CHARLOTTE, NC 28201-1335
(252) 451-2700
(252) 451-2702
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001003693
NC
363AM0700X
Medical Physician Assistant
0010-03693
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8102643
—
NC
Enumeration date
08/16/2012
Last updated
06/27/2017
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