Provider Demographics
NPI:1801194584
Name:HEUSINGER, AMY LARREUR (ANP-C)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LARREUR
Last Name:HEUSINGER
Suffix:
Gender:F
Credentials:ANP-C
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LYNN
Other - Last Name:LARREUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP-C
Mailing Address - Street 1:131 WELTON WAY
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-9163
Mailing Address - Country:US
Mailing Address - Phone:704-360-4564
Mailing Address - Fax:704-360-4553
Practice Address - Street 1:131 WELTON WAY
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-9163
Practice Address - Country:US
Practice Address - Phone:704-360-4564
Practice Address - Fax:704-360-4553
Is Sole Proprietor?:No
Enumeration Date:2011-03-04
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5005092363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health