Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | F05200690 | NC |
N | 363LA2100X | Nurse Practitioner - Acute Care | F05200690 | NC |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 5013483 | NC |
NPI | 1003428293 |
---|---|
Provider Name | Mrs. Kashari Fulks |
First Address | Charlotte, NC 28269-3103 |
Second Address | Salisbury, NC 28147-9079 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2020 |
Last Update Date | 12/01/2022 |