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1538753983
KELLY MARIE DE GROOT
CHARLOTTE, NC
NPI
1538753983
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: NC 5015315)
Enumeration Date
2021-02-25
Last Update Date
2023-05-22
Business Address
KELLY MARIE DE GROOT
901 E 4TH ST STE D
CHARLOTTE, NC 28204-2622
Phone number: 866-434-3255
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Mailing Address
KELLY MARIE DE GROOT
901 E 4TH ST STE D
CHARLOTTE, NC 28204-2622
Phone number: 866-434-3255
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