Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 201320 | NC |
Y | 363L00000X | Nurse Practitioner | 127366 | NC |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 201320 | NC |
NPI | 1427185263 |
---|---|
Provider Name | Mrs. Patricia C Bortnick |
First Address | Newton, NC 28658-9715 |
Second Address | Newton, NC 28658-9715 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2007 |
Last Update Date | 28/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
218537 | RN LICENSE (01) | NC |
5007233 | NP LICENSE (01) | NC |
7006382 | (05) | NC |
MB0570437 | DEA (01) | NC |
P09279 | (02) | NC |