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General NPI Number Information
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NPI Number | 1265735104
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Entity Type | Individual
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Provider Name | MARIE MYHAND FNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/15/2010
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Last Update Date | 12/15/2010
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Provider Practice Location Address
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Address Line | 10512 PARK RD STE 210
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City | CHARLOTTE
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State | NC
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Zip | 28210-8469
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Country | US
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Telephone | 704-790-2450
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Fax | 704-790-2451
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Provider Business Mailing Address
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Address Line | 7714 NICOLETTE CT
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City | CHARLOTTE
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State | NC
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Zip | 28215-7790
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Country | US
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Telephone | 704-564-4409
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5005006
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License Number State | NC
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