Individual
MRS. HEATHER DANA YATES-DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
110 W MEDICAL PARK DR, LEXINGTON, NC 27292-6773
(336) 248-8692
(336) 249-7348
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
103128
NC
363A00000X
Physician Assistant
Primary
103128
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103128
NC MEDICAL LICENSE
NC
05
—
8101707
—
NC
Enumeration date
03/03/2006
Last updated
11/10/2022
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