| NPI | 1831476613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE MUDGE PARKS Nurse Practitioner 704-577-4630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: NC 940100) |
| Enumeration Date | 2011-11-08 |
| Last Update Date | 2019-12-18 |