Provider Demographics
NPI:1619307956
Name:HEYWARD, FELICIA MINNIETTE (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:FELICIA
Middle Name:MINNIETTE
Last Name:HEYWARD
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:PO BOX 3149
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29151-3149
Mailing Address - Country:US
Mailing Address - Phone:803-792-9001
Mailing Address - Fax:803-792-9006
Practice Address - Street 1:259 BROAD ST STE A
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4146
Practice Address - Country:US
Practice Address - Phone:803-792-9002
Practice Address - Fax:803-792-9006
Is Sole Proprietor?:No
Enumeration Date:2013-11-23
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCTP18597363LF0000X
SC18597363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily