Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 2020-02107 | NC |
NPI | 1013218098 |
---|---|
Provider Name | Kitila Heyward |
First Address | Charlotte, NC 28219-9305 |
Second Address | Monroe, NC 28112-5086 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2010 |
Last Update Date | 06/12/2021 |