Provider Demographics
NPI:1174227276
Name:HEAPS, CHANDLER HARDEE (NP-C)
Entity type:Individual
Prefix:MRS
First Name:CHANDLER
Middle Name:HARDEE
Last Name:HEAPS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 RIVERPORT DR
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526-1916
Mailing Address - Country:US
Mailing Address - Phone:843-283-2511
Mailing Address - Fax:
Practice Address - Street 1:3793 MCDOWELL LANE MEDICAL PARK 2, SUITE 200
Practice Address - Street 2:
Practice Address - City:LITTLE RIVER
Practice Address - State:SC
Practice Address - Zip Code:29566
Practice Address - Country:US
Practice Address - Phone:843-390-0877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC27217363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily