Healthcare Provider Details

I. General information

NPI: 1114910544
Provider Name (Legal Business Name): AMY SAXTON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 09/27/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

807 SCHENCK ST STE 2
SHELBY NC
28150-5122
US

IV. Provider business mailing address

PO BOX 19305
CHARLOTTE NC
28219-9305
US

V. Phone/Fax

Practice location:
  • Phone: 980-487-2540
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number200975
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: