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General NPI Number Information
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NPI Number | 1356757348
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Entity Type | Individual
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Provider Name | CHRISTINA PRADHAN NP
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Gender | Female
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Dates
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Enumeration Date | 07/10/2014
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Last Update Date | 09/28/2023
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Provider Practice Location Address
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Address Line | 10430 PARK RD STE 100A
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City | CHARLOTTE
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State | NC
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Zip | 28210-8541
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Country | US
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Telephone | 704-259-7673
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Fax |
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Provider Business Mailing Address
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Address Line | 10430 PARK RD STE 100A
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City | CHARLOTTE
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State | NC
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Zip | 28210-8541
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Country | US
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Telephone | 704-259-7673
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F306910
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License Number State | NY
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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 | 5013127
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License Number State | NC
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