Provider Demographics
NPI:1588939318
Name:VISTA HEALTH AND WELLNESS, P.A.
Entity type:Organization
Organization Name:VISTA HEALTH AND WELLNESS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:STAMEY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:704-896-8680
Mailing Address - Street 1:16600 BIRKDALE COMMONS PKWY
Mailing Address - Street 2:SUITE E
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-6181
Mailing Address - Country:US
Mailing Address - Phone:704-896-8680
Mailing Address - Fax:704-896-8380
Practice Address - Street 1:16600 BIRKDALE COMMONS PKWY
Practice Address - Street 2:SUITE E
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-6181
Practice Address - Country:US
Practice Address - Phone:704-896-8680
Practice Address - Fax:704-896-8380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-12
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC193480363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty