Healthcare Provider Details

I. General information

NPI: 1932080660
Provider Name (Legal Business Name): HEATHER LEE BYBEE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER LEE JOUBERT

II. Dates (important events)

Enumeration Date: 09/09/2025
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

571 S ALLEN RD
FLAT ROCK NC
28731-9447
US

IV. Provider business mailing address

571 S ALLEN RD
FLAT ROCK NC
28731-9447
US

V. Phone/Fax

Practice location:
  • Phone: 866-466-9734
  • Fax: 855-356-3998
Mailing address:
  • Phone: 828-692-6178
  • Fax: 828-692-2365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number5023075
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5023075
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number5023075
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number5023075
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number382231
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: