| NPI | 1033664834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA KAY BLEVINS Practice Manager 704-487-5228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 210062) |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2016-08-22 |