Healthcare Provider Details

I. General information

NPI: 1053559195
Provider Name (Legal Business Name): WOMEN'S INTEGRATIVE HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2009
Last Update Date: 01/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 S SWING RD
GREENSBORO NC
27409-2009
US

IV. Provider business mailing address

335 S SWING RD
GREENSBORO NC
27409-2009
US

V. Phone/Fax

Practice location:
  • Phone: 336-632-9944
  • Fax:
Mailing address:
  • Phone: 336-632-9944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number940103
License Number StateNC

VIII. Authorized Official

Name: KRISTIE M CONNERTON
Title or Position: BILLING MANAGER
Credential:
Phone: 336-830-3308