Individual
MRS. HEATHER ANDERSON GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN FNP-BC
Contact information
Practice address
171 W WILKES MEDICAL CENTER RD, FERGUSON, NC 28624-8925
(336) 973-7050
(336) 973-9370
Mailing address
PO BOX 602658, CHARLOTTE, NC 28260-2658
(336) 716-2011
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5005840
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NCA970A
MEDICARE PTAN INDIVIDUAL, UNDER WILKES PHYSICIAN NETWORK
NC
Enumeration date
10/10/2012
Last updated
07/21/2022
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