1700545753 NPI number — DR. ANNETTE GWALTNEY HEAVNER DNP, FNP

Table of content: DR. ANNETTE GWALTNEY HEAVNER DNP, FNP (NPI 1700545753)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700545753 NPI number — DR. ANNETTE GWALTNEY HEAVNER DNP, FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HEAVNER
Provider First Name:
ANNETTE
Provider Middle Name:
GWALTNEY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DNP, FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GWALTNEY
Provider Other First Name:
ANNETTE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1700545753
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/17/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2226 4TH ST NE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HICKORY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28601-1453
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-234-5999
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1205 N CENTER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HICKORY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28601-3759
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-732-5800
Provider Business Practice Location Address Fax Number:
828-732-5801
Provider Enumeration Date:
12/16/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  5015522 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LF0000X , with the licence number: GWAL-J8F9N , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)