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NPI Code Detail

MEDICARE: HEATHER BALLEW MSN-NNP

MEDICARE: HEATHER BALLEW MSN-NNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LN0000XNeonatal Nurse PractitionerAPN.0993346-NPCO
2363L00000XNurse Practitioner5013816NC

General Provider Information

NPI Number : 1104341213
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER BALLEW MSN-NNP
Provider Business Mailing Address
First Line : 510 CAROLINA BAY DR
Second Line :
City : WILMINGTON
State : NC
Zip : 28403-2041
Country : US
Telephone Number : 910-612-6932
Fax Number :
Provider Business Practice Location Address
First Line : 2131 S 17TH ST
Second Line :
City : WILMINGTON
State : NC
Zip : 28401-7407
Country : US
Telephone Number : 910-667-2970
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2017
Last Update Date : 02/04/2026

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Directions to “ HEATHER BALLEW MSN-NNP” Practice Location

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