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General NPI Number Information
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NPI Number | 1962934059
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Entity Type | Organization
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Legal Business Name | ADVANCED PRACTICE CARE, INC
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Dates
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Enumeration Date | 03/29/2017
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Last Update Date | 03/29/2017
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Provider Practice Location Address
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Address Line | 1914 J N PEASE PL STE 138
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City | CHARLOTTE
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State | NC
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Zip | 28262-4504
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Country | US
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Telephone | 704-919-3564
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Fax |
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Provider Business Mailing Address
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Address Line | 1914 J N PEASE PL STE 138
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City | CHARLOTTE
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State | NC
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Zip | 28262-4504
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Country | US
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Telephone | 704-919-3564
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | STEPHANIE BRATHWAITE
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Credential | N.P
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Telephone | 704-919-3564
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1548675648
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1548520935
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License Number State | NC
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