Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | 5008049 | NC |
NPI | 1003286121 |
---|---|
Provider Name | Carrie Doss |
First Address | Burlington, NC 27215-8776 |
Second Address | Burlington, NC 27215-8776 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2015 |
Last Update Date | 01/10/2015 |