Individual
MS. PATRICIA HEASTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
4414 LAKE BOONE TRL, STE 205, RALEIGH, NC 27607-7513
(919) 788-4444
(919) 788-4464
Mailing address
4414 LAKE BOONE TRL, STE 205, RALEIGH, NC 27607-7513
(919) 788-4444
(919) 788-4464
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
940048
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2599199A
MEDICARE
NC
Enumeration date
11/03/2005
Last updated
06/04/2012
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