Provider Demographics
NPI:1073932646
Name:OLIVER, HEATHER PUTNAM (APRN)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:PUTNAM
Last Name:OLIVER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 S HIGH POINT RD
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29301-3007
Mailing Address - Country:US
Mailing Address - Phone:864-680-2340
Mailing Address - Fax:
Practice Address - Street 1:5895 REIDVILLE RD
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:SC
Practice Address - Zip Code:29369-8409
Practice Address - Country:US
Practice Address - Phone:864-486-6990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18739363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily