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General NPI Number Information
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NPI Number | 1487260451
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Entity Type | Individual
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Provider Name | JO ELLEN INMAN-PUCKETT DNP, AGPCNP
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Gender | Female
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Dates
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Enumeration Date | 09/16/2020
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Last Update Date | 09/16/2020
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Provider Practice Location Address
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Address Line | 31 SWISS PINE CT
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City | SPRUCE PINE
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State | NC
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Zip | 28777-8704
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Country | US
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Telephone | 828-765-1444
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Fax |
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Provider Business Mailing Address
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Address Line | 216 GREENWAY ST
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-7264
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Country | US
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Telephone | 704-948-6169
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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 | 5013551
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License Number State | NC
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