MEDICARE: TSHIKWAKWA KASEMBWE FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	5020526	NC

General Provider Information

NPI Number	:	1326877572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TSHIKWAKWA KASEMBWE FNP-BC

Provider Business Mailing Address
First Line	:	537 WEST SUGAR CREEK RD # 201
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28213
Country	:	US
Telephone Number	:	704-222-5528
Fax Number	:

Provider Business Practice Location Address
First Line	:	537 W SUGAR CREEK RD STE 201
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28213-6103
Country	:	US
Telephone Number	:	704-979-8210
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2024
Last Update Date	:	07/27/2024

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Directions to “ TSHIKWAKWA KASEMBWE FNP-BC” Practice Location

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