Healthcare Provider Details

I. General information

NPI: 1770828881
Provider Name (Legal Business Name): JENNIFER RAMOS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2012
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2365 SPRINGS RD NE
HICKORY NC
28601-3067
US

IV. Provider business mailing address

200 E 2ND AVE
GASTONIA NC
28052-4358
US

V. Phone/Fax

Practice location:
  • Phone: 828-256-2112
  • Fax: 828-256-2393
Mailing address:
  • Phone: 704-874-1904
  • Fax: 704-874-0707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5005961
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: