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General NPI Number Information
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NPI Number | 1316549892
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Entity Type | Individual
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Provider Name | ANGIE MOFFITT KEPLEY FNP
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Gender | Female
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Dates
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Enumeration Date | 11/10/2020
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Last Update Date | 11/10/2022
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Provider Practice Location Address
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Address Line | 300 MARKET ST
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City | ROCKWELL
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State | NC
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Zip | 28138-8886
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Country | US
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Telephone | 704-297-9333
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Fax |
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Provider Business Mailing Address
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Address Line | 1419 OAK GROVE LN
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City | SALISBURY
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State | NC
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Zip | 28146-6975
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Country | US
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Telephone | 704-202-9246
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5013843
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5013843
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 178629
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License Number State | NC
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