Individual
MRS. HEIDI LYNN MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1235 RAMSEY ST, FAYETTEVILLE, NC 28301-4401
(910) 433-3708
(910) 321-7103
Mailing address
2135 RAMSEY STREET, FAYETTEVILLE, NC 28301-4401
(910) 433-3708
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
858950
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2995065
CIGNA MEDICARE
NC
Enumeration date
07/16/2010
Last updated
09/15/2010
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