Healthcare Provider Details

I. General information

NPI: 1053428441
Provider Name (Legal Business Name): JILL HEATH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 08/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 E CHESTNUT ST STE 4
ASHEVILLE NC
28801-2480
US

IV. Provider business mailing address

223 E CHESTNUT ST STE 4
ASHEVILLE NC
28801-2480
US

V. Phone/Fax

Practice location:
  • Phone: 828-350-8149
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number34347
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: