Provider Demographics
NPI:1700184348
Name:PETERS, HEATHER BARKER (NP)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:BARKER
Last Name:PETERS
Suffix:
Gender:F
Credentials:NP
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 924
Mailing Address - Street 2:
Mailing Address - City:WEST JEFFERSON
Mailing Address - State:NC
Mailing Address - Zip Code:28694-0924
Mailing Address - Country:US
Mailing Address - Phone:336-646-7442
Mailing Address - Fax:336-844-2108
Practice Address - Street 1:17 EAST BUCK MOUNTAIN ROAD
Practice Address - Street 2:
Practice Address - City:WEST JEFFERSON
Practice Address - State:NC
Practice Address - Zip Code:28694
Practice Address - Country:US
Practice Address - Phone:336-646-7442
Practice Address - Fax:336-844-2108
Is Sole Proprietor?:No
Enumeration Date:2011-03-07
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5005072363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily