Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 2009-01643 | NC |
Y | 2080P0205X | Pediatric Endocrinologist | 2009-01643 | NC |
NPI | 1326249400 |
---|---|
Provider Name | Jennifer A. Sutter |
First Address | Charlotte, NC 28275-1069 |
Second Address | Greenville, NC 27834-3736 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2007 |
Last Update Date | 14/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
155K2 | BCBSNC (01) | NC |
5913977 | (05) | NC |