Provider Demographics
NPI:1225404866
Name:HETHER, MARY MARGARET TRIPP (FNP-C)
Entity Type:Individual
Prefix:DR
First Name:MARY MARGARET
Middle Name:TRIPP
Last Name:HETHER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 W BROAD ST STE B
Mailing Address - Street 2:
Mailing Address - City:DUNN
Mailing Address - State:NC
Mailing Address - Zip Code:28334-4605
Mailing Address - Country:US
Mailing Address - Phone:910-591-1277
Mailing Address - Fax:910-255-5147
Practice Address - Street 1:1120 W BROAD ST STE B
Practice Address - Street 2:
Practice Address - City:DUNN
Practice Address - State:NC
Practice Address - Zip Code:28334-4605
Practice Address - Country:US
Practice Address - Phone:910-591-1277
Practice Address - Fax:910-255-5147
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-18
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007894363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner