Healthcare Provider Details

I. General information

NPI: 1265187306
Provider Name (Legal Business Name): ROYAL KARTIER BEAUYT SPA HEALTH AND WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2022
Last Update Date: 02/17/2022
Certification Date: 02/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4410 MINT HILL VILLAGE LN STE 201
MINT HILL NC
28227-0528
US

IV. Provider business mailing address

4410 MINT HILL VILLAGE LN STE 201
MINT HILL NC
28227-0528
US

V. Phone/Fax

Practice location:
  • Phone: 980-299-9991
  • Fax:
Mailing address:
  • Phone: 980-299-9991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. NICOLE E CLARK WARD
Title or Position: OWNER
Credential: DNP FNP-BC
Phone: 980-299-9991