Basic Information
| Provider Information | |||||||||
| NPI: | 1770125163 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GIBSON | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 75 UPHILL RD | ||||||||
| Address2: | |||||||||
| City: | MARBLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 289059223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8283618635 | ||||||||
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| Practice Location | |||||||||
| Address1: | 80 VETERANS BLVD | ||||||||
| Address2: | |||||||||
| City: | BRYSON CITY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287138816 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8285384546 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2019 | ||||||||
| LastUpdateDate: | 06/16/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/16/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | F10190821 | NC | N | Allopathic & Osteopathic Physicians | Family Medicine | 363L00000X | F10190821 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.