Provider Demographics
NPI:1336909191
Name:HEILEMANN, MEGAN (CPNP-PC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:HEILEMANN
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 WATERLYNN RIDGE RD UNIT C
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-5476
Mailing Address - Country:US
Mailing Address - Phone:704-657-5867
Mailing Address - Fax:
Practice Address - Street 1:8301 MAGNOLIA ESTATES DR STE 16
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-8053
Practice Address - Country:US
Practice Address - Phone:704-895-9060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5019867363LP0200X
NC311639163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics