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General NPI Number Information
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NPI Number | 1700493889
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Entity Type | Organization
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Legal Business Name | MINUTE MEDICAL CARE, PLLC
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Dates
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Enumeration Date | 09/23/2020
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Last Update Date | 10/29/2020
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Provider Practice Location Address
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Address Line | 1218 EAST BLVD STE B
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City | CHARLOTTE
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State | NC
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Zip | 28203-6158
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Country | US
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Telephone | 704-997-9745
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Fax | 844-646-8834
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Provider Business Mailing Address
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Address Line | 400 GILEAD RD UNIT 651
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-6899
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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 | CO-OWNER, MD
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Name | TIFFANY JACKSON
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Credential | MD
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Telephone | 704-997-9745
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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