Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 226571 | NC |
NPI | 1174981252 |
---|---|
Provider Name | Trisha L. Abernathy |
First Address | Statesville, NC 28677-9011 |
Second Address | Charlotte, NC 28204-2515 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2016 |
Last Update Date | 04/02/2016 |