| NPI | 1790143436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD ALLEN KEPP Owner 704-986-3900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 9400873) |
| 363LF0000X Nurse Practitioner, Family | |
| 363LW0102X Nurse Practitioner, Women's Health | |
| Enumeration Date | 2016-02-09 |
| Last Update Date | 2021-03-17 |