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NPI Code Detail

MEDICARE: MRS. HEIDI KATHERINE STODDARD NP-C

MEDICARE: MRS. HEIDI KATHERINE STODDARD NP-C
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
1363LA2200XAdult Health Nurse Practitioner5009431NC

General Provider Information

NPI Number : 1912320938
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HEIDI KATHERINE STODDARD NP-C
Provider Business Mailing Address
First Line : 17914 JOHN CONNOR RD
Second Line :
City : CORNELIUS
State : NC
Zip : 28031-7661
Country : US
Telephone Number : 704-896-2181
Fax Number :
Provider Business Practice Location Address
First Line : 14230 HUNTERS RD
Second Line :
City : HUNTERSVILLE
State : NC
Zip : 28078-7335
Country : US
Telephone Number : 704-947-6849
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2014
Last Update Date : 04/05/2017

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