MEDICARE: VISTA HEALTH AND WELLNESS, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	193480	NC

General Provider Information

NPI Number	:	1588939318
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISTA HEALTH AND WELLNESS, P.A.

Provider Business Mailing Address
First Line	:	16600 BIRKDALE COMMONS PKWY
Second Line	:	SUITE E
City	:	HUNTERSVILLE
State	:	NC
Zip	:	28078-6181
Country	:	US
Telephone Number	:	704-896-8680
Fax Number	:	704-896-8380

Provider Business Practice Location Address
First Line	:	16600 BIRKDALE COMMONS PKWY
Second Line	:	SUITE E
City	:	HUNTERSVILLE
State	:	NC
Zip	:	28078-6181
Country	:	US
Telephone Number	:	704-896-8680
Fax Number	:	704-896-8380

Authorized Official
Title or Position	:	OWNER
Name	:	HEATHER STAMEY
Credential	:	FNP-BC
Telephone Number	:	704-896-8680

Provider Enumeration Date	:	03/12/2012
Last Update Date	:	11/07/2024

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