Provider Demographics
NPI:1770125163
Name:GIBSON, HEATHER C (FNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:C
Last Name:GIBSON
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 UPHILL RD
Mailing Address - Street 2:
Mailing Address - City:MARBLE
Mailing Address - State:NC
Mailing Address - Zip Code:28905-9223
Mailing Address - Country:US
Mailing Address - Phone:828-361-8635
Mailing Address - Fax:
Practice Address - Street 1:80 VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:BRYSON CITY
Practice Address - State:NC
Practice Address - Zip Code:28713-8816
Practice Address - Country:US
Practice Address - Phone:828-538-4546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-17
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF10190821207Q00000X
NC5012456363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine