Healthcare Provider Details

I. General information

NPI: 1124207758
Provider Name (Legal Business Name): KAREN WILKIE HOERNER RN, MSN,PNP,FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2007
Last Update Date: 10/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 COTTON CREEK RD
STAR NC
27356-7954
US

IV. Provider business mailing address

60 COMMERCE PLAZA CIR
PEMBROKE NC
28372-7386
US

V. Phone/Fax

Practice location:
  • Phone: 910-428-9020
  • Fax: 910-428-9022
Mailing address:
  • Phone: 910-521-2900
  • Fax: 910-775-9165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number056780
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number56780
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: