Individual
MRS. HEATHER THOMPSON MACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
250 CHARLOIS BLVD, WINSTON SALEM, NC 27103
(336) 718-1000
(336) 718-1052
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(336) 718-1000
(336) 718-1052
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
900298
NC
363LA2200X
Adult Health Nurse Practitioner
900298
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7003716
—
NC
Enumeration date
11/04/2005
Last updated
10/25/2020
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