Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 600046 | NC |
NPI | 1003990458 |
---|---|
Provider Name | Caroline Adams |
First Address | Charlotte, NC 28219-9305 |
Second Address | Salisbury, NC 28147-1364 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 27/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S68763 | (02) | NC |