Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 5006918 | NC |
N | 363L00000X | Nurse Practitioner | 5006918 | NC |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 5006918 | NC |
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 5006918 | NC |
N | 363LP2300X | Nurse Practitioner - Primary Care | 5006918 | NC |
NPI | 1558775163 |
---|---|
Provider Name | Megan Rhyne-Cousar |
First Address | Mooresville, NC 28117-5516 |
Second Address | Mooresville, NC 28117-5516 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2014 |
Last Update Date | 24/01/2022 |