Individual
MRS. HEATHER CAUDILL PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-C
Contact information
Practice address
200 MEDICAL PARK DR STE 400, CONCORD, NC 28025-0906
(704) 786-1108
(704) 782-1826
Mailing address
200 MEDICAL PARK DR STE 400, CONCORD, NC 28025-0906
(704) 786-1108
(704) 782-1826
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
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