Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 5009839 | NC |
NPI | 1003335860 |
---|---|
Provider Name | Holly K.g. Sawyer |
First Address | Boone, NC 28607-3866 |
Second Address | Boone, NC 28607-5008 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2017 |
Last Update Date | 13/09/2017 |