Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 2007-00877 | NC |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 2007-00877 | NC |
N | 207RH0002X | Hospice and Palliative Medicine | 2007-00877 | NC |
NPI | 1356484232 |
---|---|
Provider Name | Kimberly Anne Case |
First Address | Charlotte, NC 28204-3215 |
Second Address | Charlotte, NC 28204-3215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2007 |
Last Update Date | 12/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
146F7 | BLUE CROSS (01) | NC |
202028 | MEDCOST (01) | NC |
3810009712 | (05) | WV |
5907442 | (05) | NC |
810639 | PARTNERS (01) | NC |
9746068 | AETNA (01) | NC |
Q77008 | (05) | SC |