Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 2018-00703 | NC |
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 81589 | SC |
NPI | 1497047633 |
---|---|
Provider Name | Nicole Cyrille-Superville |
First Address | Charlotte, NC 28219-9305 |
Second Address | Charlotte, NC 28204-2963 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2011 |
Last Update Date | 07/01/2022 |