Individual
MRS. HEATHER CAUDILL PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-C
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
900455
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900455
NC MEDICAL BOARD LICENSE
NC
Enumeration date
07/12/2006
Last updated
11/11/2021
Update your record
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