Healthcare Provider Details

I. General information

NPI: 1700948411
Provider Name (Legal Business Name): HEATHER FOUTS KUHL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2006
Last Update Date: 06/23/2022
Certification Date: 06/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 S MAIN ST
DAVIDSON NC
28036-8096
US

IV. Provider business mailing address

127 S MAIN ST
DAVIDSON NC
28036-8096
US

V. Phone/Fax

Practice location:
  • Phone: 704-892-7211
  • Fax:
Mailing address:
  • Phone: 704-892-7211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5002308
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number005002308
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: