Healthcare Provider Details

I. General information

NPI: 1629900493
Provider Name (Legal Business Name): BLUE HEEL CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12148 CAMBRIDGE SQUARE DR
CORNELIUS NC
28031-5824
US

IV. Provider business mailing address

12148 CAMBRIDGE SQUARE DR
CORNELIUS NC
28031-5824
US

V. Phone/Fax

Practice location:
  • Phone: 980-721-2192
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name: BRUCE LE
Title or Position: PRESIDENT
Credential:
Phone: 980-721-2192