Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 33950 | NC |
NPI | 1023097664 |
---|---|
Provider Name | Linda Bresnahan |
First Address | Charlotte, NC 28219-9305 |
Second Address | Davidson, NC 28036-7601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2006 |
Last Update Date | 16/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F08799 | (02) | NC |