Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 33571 | NC |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 33571 | NC |
NPI | 1417075813 |
---|---|
Provider Name | Janet Uhlan Crook |
First Address | Charlotte, NC 28247-0408 |
Second Address | Charlotte, NC 28226-8198 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 02/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
84454 | BLUE CROSS BLUE SHIELD (01) | NC |
8984454 | (05) | NC |
E40888 | (02) |