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General NPI Number Information
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NPI Number | 1629272562
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Entity Type | Individual
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Provider Name | HEATHER KATHLEEN MCDONNELL BSN, RN, CCM
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Gender | Female
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 9900 DOMINION CREST DR
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City | CHARLOTTE
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State | NC
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Zip | 28269-7027
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Country | US
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Telephone | 631-645-7757
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Fax |
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Provider Business Mailing Address
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Address Line | 9900 DOMINION CREST DR
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City | CHARLOTTE
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State | NC
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Zip | 28269-7027
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Country | US
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Telephone | 631-645-7757
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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 | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 290226
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 163WM0102X
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Taxonomy Name | Maternal Newborn Registered Nurse
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License Number | 290226
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 163WM0102X
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Taxonomy Name | Maternal Newborn Registered Nurse
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License Number | 527260
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 163WX0002X
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Taxonomy Name | High-Risk Obstetric Registered Nurse
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License Number | 290226
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 163WP1700X
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Taxonomy Name | Perinatal Registered Nurse
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License Number | 290226
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License Number State | NC
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