Healthcare Provider Details

I. General information

NPI: 1124446018
Provider Name (Legal Business Name): HEATHER L FLYNT FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2014
Last Update Date: 11/07/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 S CHURCH ST
ASHEBORO NC
27203-5671
US

IV. Provider business mailing address

529 S CHURCH ST
ASHEBORO NC
27203-5671
US

V. Phone/Fax

Practice location:
  • Phone: 336-847-9950
  • Fax:
Mailing address:
  • Phone: 336-847-9950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF0314367
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: