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Individual

MRS. HEATHER ELIZABETH SHIFLETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1040 EDGEWATER CORPORATE PKWY STE 104, FORT MILL, SC 29707-4526
(803) 547-8660
(704) 544-0172
Mailing address
8015 FARMBROOK DR, WAXHAW, NC 28173-7123
(704) 667-2650
(704) 544-0172

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
102370
NC
363AS0400X
Surgical Physician Assistant
1328
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1619901568
NC
05
1865PA
SC
05
8102101
NC
Enumeration date
07/10/2006
Last updated
04/18/2024
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