Basic Information
| Provider Information | |||||||||
| NPI: | 1548581804 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MORRISON | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | RIEGEL | ||||||||
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| Credential: | AUD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6035 FAIRVIEW RD | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282103256 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7042953000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 645 AMALIA STREET NE | ||||||||
| Address2: | |||||||||
| City: | CONCORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280252434 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7042953255 | ||||||||
| FaxNumber: | 7042953279 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2010 | ||||||||
| LastUpdateDate: | 04/26/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 9039 | NC | Y | Speech, Language and Hearing Service Providers | Audiologist |
ID Information
| ID | Type | State | Issuer | Description | 7413590 | 05 | NC | MEDICAID | 9054855 | 01 | AETNA | OTHER | 165G3 | 01 | NC | BCBSNC | OTHER | 30110301 | 01 | SC | SELECT HEALTH OF SC | OTHER | P01293987 | 01 | NC | RAILROAD MEDICARE | OTHER | SAN083 | 05 | SC | MEDICAID | 0262634 | 01 | CIGNA | OTHER |