Individual provider · Type 1 NPI

Heather Elizabeth Gordon Wallace, FNP

Family Nurse Practitioner · Charleston, SC

NPI number 1962993634 Active

Practice location

1879 Savage Rd
Charleston, SC 29407-4726

Fax (843) 763-7411

Mailing address

PO Box 751649
Charlotte, NC 28275-1649

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X21745 (SC)

Family Nurse Practitioner: Definition to come...

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About NPI 1962993634

Heather Elizabeth Gordon Wallace, FNP's National Provider Identifier is 1962993634, issued on May 29, 2018. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Charleston, SC. The record was last updated on Mar 30, 2026.