Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 108816 | NC |
N | 363LN0000X | Nurse Practitioner - Neonatal | 108816 | NC |
NPI | 1205117835 |
---|---|
Provider Name | Karen Marie Sweetwyne-Thomas |
First Address | Charlotte, NC 28260-1372 |
Second Address | Charlotte, NC 28203-5865 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2011 |
Last Update Date | 06/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1205117835 | (05) | NC |
7005316 | (05) | NC |