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General NPI Number Information
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NPI Number | 1669268397
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Entity Type | Organization
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Legal Business Name | KINDBODY PC
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Dates
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Enumeration Date | 04/18/2025
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 420 PROVIDENCE RD
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City | CHARLOTTE
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State | NC
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Zip | 28207
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Country | US
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Telephone | 980-242-5345
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Fax | 980-895-4525
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Provider Business Mailing Address
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Address Line | 1455 N MILWAUKEE AVE FL 2
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City | CHICAGO
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State | IL
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Zip | 60622-2015
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SVP, PAYOR RELATIONS
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Name | MARIANNE F DEBENEDICTIS
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Credential |
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Telephone | 713-254-3601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number |
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License Number State |
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