Provider Demographics
NPI:1720047517
Name:NORTON, HEATHER L (ACNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:L
Last Name:NORTON
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 S LADD CT
Mailing Address - Street 2:
Mailing Address - City:DANIEL ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29492-7562
Mailing Address - Country:US
Mailing Address - Phone:404-441-2508
Mailing Address - Fax:
Practice Address - Street 1:913 BOWMAN RD STE 105
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464
Practice Address - Country:US
Practice Address - Phone:843-856-9530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN149596363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA167430358BMedicaid
GA167430358CMedicaid
GA167430358DMedicaid
GA167430358EMedicaid
GA167430358FMedicaid
GA167430358CMedicaid