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General NPI Number Information
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NPI Number | 1528542917
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Entity Type | Individual
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Provider Name | KRYSTLE LYNETTE MCGEE
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Gender | Female
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Dates
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Enumeration Date | 09/20/2018
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Last Update Date | 06/30/2023
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Provider Practice Location Address
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Address Line | 4692 BROWNSBORO RD
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City | WINSTON SALEM
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State | NC
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Zip | 27106-3410
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Country | US
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Telephone | 336-991-9276
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Fax |
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Provider Business Mailing Address
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Address Line | 831 SINCLAIR DR
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City | MONROE
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State | NC
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Zip | 28112-7738
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Country | US
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Telephone | 704-993-7190
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 221743
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 22332
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 5014315
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License Number State | NC
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