Maria Obraztsova
Nurse Practitioner - Gerontology
100 Medical Park Dr Ste 210
Concord
, North Carolina 28025-2948
Maria Obraztsova
Nurse Practitioner - Gerontology
100 Medical Park Dr Ste 210
Concord
, North Carolina 28025-2948
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About
Features
Specialties
- Nurse Practitioner - Gerontology
Languages spoken
- English
Location
First Address
- Maria Obraztsova
- Po Box 19305
- Charlotte, NC
- Zip : 28219-9305
- Phone :
Second Address
- Maria Obraztsova
- 100 Medical Park Dr Ste 210
- Concord, NC
- Zip : 28025-2948
- Phone : (704) 403-6100
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LG0600X | Nurse Practitioner - Gerontology | 5008471 | NC |
National Provider Identifier
| NPI | 1053773812 |
|---|---|
| Provider Name | Maria Obraztsova |
| First Address | Charlotte, NC 28219-9305 |
| Second Address | Concord, NC 28025-2948 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/03/2016 |
| Last Update Date | 28/09/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| NCT170A | (02) | NC |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.