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General NPI Number Information
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NPI Number | 1861242083
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Entity Type | Organization
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Legal Business Name | KV HEALTH TECHNOLOGIES
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Dates
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Enumeration Date | 03/22/2024
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Last Update Date | 03/22/2024
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Provider Practice Location Address
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Address Line | 136 CARBONTON RD
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City | SANFORD
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State | NC
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Zip | 27330-4000
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Country | US
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Telephone | 910-600-6229
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Fax |
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Provider Business Mailing Address
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Address Line | 15000 WESTON PKWY
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City | CARY
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State | NC
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Zip | 27513-2118
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Country | US
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Telephone | 407-305-3791
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ERICA MICHELE
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Credential |
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Telephone | 407-305-3791
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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