Basic Information
Provider Information
NPI: 1538460688
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WHISNANT
FirstName: HEATHER
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential: FNP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 521 SPRING FOREST RD APT A
Address2:  
City: GREENVILLE
State: NC
PostalCode: 278347233
CountryCode: US
TelephoneNumber: 8284437836
FaxNumber:  
Practice Location
Address1: 1588 GEER HWY
Address2:  
City: TRAVELERS REST
State: SC
PostalCode: 296909204
CountryCode: US
TelephoneNumber: 8648361109
FaxNumber: 8647510479
Other Information
ProviderEnumerationDate: 11/05/2010
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X234690NCN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
163W00000X234690NCN Nursing Service ProvidersRegistered Nurse 
363LF0000X20861SCY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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