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Individual

MRS. HEATHER JEAN MATHEW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
1401 MATTHEWS TOWNSHIP PKWY STE 110, MATTHEWS, NC 28105-5403
(704) 264-3500
(704) 417-4989
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 264-3500
(704) 417-4989

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5009877
NC
363LA2200X
Adult Health Nurse Practitioner
5009877
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
199365
NURSE LICENSE
NC
01
5009877
NP APPROVAL #
NC
01
F08170925
FNP CERTIFICATION NUMBER
Enumeration date
09/17/2017
Last updated
07/21/2022
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