Provider Demographics
NPI:1770567802
Name:HEER, KATHLEEN E (DO)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:E
Last Name:HEER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 517
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:28337-0517
Mailing Address - Country:US
Mailing Address - Phone:910-862-6672
Mailing Address - Fax:910-862-6674
Practice Address - Street 1:300 E MCKAY ST STE F
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:NC
Practice Address - Zip Code:28337-9037
Practice Address - Country:US
Practice Address - Phone:910-862-6672
Practice Address - Fax:910-862-6674
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC604207V00000X
NC2007-00603207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
57-0965445OtherEIN