Healthcare Provider Details

I. General information

NPI: 1326605759
Provider Name (Legal Business Name): KARA WALDROP NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2019
Last Update Date: 05/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 E RICH BLVD
ELIZABETH CITY NC
27909-5518
US

IV. Provider business mailing address

135 E RICH BLVD
ELIZABETH CITY NC
27909-5518
US

V. Phone/Fax

Practice location:
  • Phone: 252-333-1277
  • Fax: 252-333-1877
Mailing address:
  • Phone: 252-333-1277
  • Fax: 252-333-1877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5011777
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: