Provider Demographics
NPI:1033776240
Name:THOMAS, HEATHER ROSS (DNP, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:ROSS
Last Name:THOMAS
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1035 DALE EARNHARDT BLVD
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28083-4477
Practice Address - Country:US
Practice Address - Phone:704-316-1886
Practice Address - Fax:704-316-1887
Is Sole Proprietor?:No
Enumeration Date:2019-05-22
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NCF05190359363LF0000X
NC5011821363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily