Healthcare Provider Details

I. General information

NPI: 1023756996
Provider Name (Legal Business Name): INSIGHTFUL CHOICE MANAGED CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2022
Last Update Date: 05/21/2022
Certification Date: 05/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8654 BROOKINGS DR
CHARLOTTE NC
28269-6244
US

IV. Provider business mailing address

8654 BROOKINGS DR
CHARLOTTE NC
28269-6244
US

V. Phone/Fax

Practice location:
  • Phone: 704-651-6868
  • Fax:
Mailing address:
  • Phone: 704-651-6868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER LESTER
Title or Position: CO-OWNER
Credential: RN
Phone: 704-243-7047