Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 201606 | NC |
NPI | 1306013123 |
---|---|
Provider Name | Mrs. Kimberly Carlyle Cherry |
First Address | Greenville, NC 27834-8198 |
Second Address | Greenville, NC 27834-8198 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2008 |
Last Update Date | 12/05/2008 |