Individual
VIVIAN MARIE HEADEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
209 S 2ND AVE, SILER CITY, NC 27344-3429
(919) 663-1366
(919) 663-1369
Mailing address
1109 SUNRISE PL, SILER CITY, NC 27344-9442
(919) 663-1891
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
3408022
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408022
—
NC
Enumeration date
02/15/2007
Last updated
07/09/2007
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