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General NPI Number Information
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NPI Number | 1538718671
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Entity Type | Individual
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Provider Name | HEATHER THOMPSON RN
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Gender | Female
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Dates
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Enumeration Date | 09/11/2019
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Last Update Date | 09/11/2019
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Provider Practice Location Address
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Address Line | 5108 REAGAN DR STE 9
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City | CHARLOTTE
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State | NC
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Zip | 28206-1394
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Country | US
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Telephone | 704-567-0790
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Fax | 833-834-2555
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Provider Business Mailing Address
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Address Line | 2809 LOXDALE FARMS DR
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City | MONROE
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State | NC
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Zip | 28110-7728
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Country | US
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Telephone | 704-618-6678
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 231494
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License Number State | NC
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