Healthcare Provider Details

I. General information

NPI: 1952601338
Provider Name (Legal Business Name): HEATHER JENNIE DAY APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2010
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

526 MOYE BLVD
GREENVILLE NC
27834-2848
US

IV. Provider business mailing address

1804 RONDO DR
GREENVILLE NC
27858-5341
US

V. Phone/Fax

Practice location:
  • Phone: 252-847-7150
  • Fax: 252-847-3891
Mailing address:
  • Phone: 615-521-1622
  • Fax: 252-209-3018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPN0000015317
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPN0000015317
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number5005678
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: