Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 159789 | NC |
N | 363LP2300X | Nurse Practitioner - Primary Care | 5007259 | NC |
NPI | 1043614670 |
---|---|
Provider Name | Misty Setzer Cline |
First Address | Charlotte, NC 28260-1884 |
Second Address | Cherryville, NC 28021-3423 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2014 |
Last Update Date | 21/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1043614670 | (05) | NC |