Provider Demographics
NPI:1295324861
Name:WILLIAMS, HEATHER EVANS (AGACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:EVANS
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 VIRGINIA RD # 629
Mailing Address - Street 2:
Mailing Address - City:EDENTON
Mailing Address - State:NC
Mailing Address - Zip Code:27932-9668
Mailing Address - Country:US
Mailing Address - Phone:252-482-8451
Mailing Address - Fax:252-482-6435
Practice Address - Street 1:211 VIRGINIA RD
Practice Address - Street 2:
Practice Address - City:EDENTON
Practice Address - State:NC
Practice Address - Zip Code:27932-9668
Practice Address - Country:US
Practice Address - Phone:252-482-8451
Practice Address - Fax:252-482-6435
Is Sole Proprietor?:No
Enumeration Date:2021-01-18
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC172112363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care