Provider Demographics
NPI:1548581804
Name:MORRISON, HEATHER RIEGEL (AUD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:RIEGEL
Last Name:MORRISON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6035 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3256
Mailing Address - Country:US
Mailing Address - Phone:704-295-3000
Mailing Address - Fax:
Practice Address - Street 1:645 AMALIA STREET NE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2434
Practice Address - Country:US
Practice Address - Phone:704-295-3255
Practice Address - Fax:704-295-3279
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9039231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7413590Medicaid
9054855OtherAETNA
NC165G3OtherBCBSNC
SC30110301OtherSELECT HEALTH OF SC
NCP01293987OtherRAILROAD MEDICARE
SCSAN083Medicaid
0262634OtherCIGNA
NCQ36591AMedicare PIN