Individual
MS. HEATHER DAWN PETRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2404 WISE RD, CONWAY, SC 29526-5521
(843) 365-8884
(843) 365-6697
Mailing address
2404 WISE RD, CONWAY, SC 29526-5521
(843) 365-8884
(843) 365-6697
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
26858
SC
363LF0000X
Family Nurse Practitioner
Primary
70678
WV
363LF0000X
Family Nurse Practitioner
APRN70678
WV
Other
Enumeration date
07/02/2014
Last updated
07/11/2025
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