Healthcare Provider Details

I. General information

NPI: 1467005033
Provider Name (Legal Business Name): JUDY FOSTER PINNOCK RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2019
Last Update Date: 07/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1408 E FRANKLIN ST
MONROE NC
28112-5160
US

IV. Provider business mailing address

284 EXECUTIVE PARK DR STE 100
CONCORD NC
28025-1833
US

V. Phone/Fax

Practice location:
  • Phone: 704-635-2080
  • Fax: 704-635-2089
Mailing address:
  • Phone: 704-939-1100
  • Fax: 704-939-1173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number068362
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: