| NPI | 1609820729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARA RICHARDSON Assistant Treasurer 704-631-0450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2025-10-08 |