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General NPI Number Information
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NPI Number | 1992081335
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Entity Type | Organization
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Legal Business Name | SAFE HAVEN FAMILY PRACTICE, PLLC
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Dates
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Enumeration Date | 10/31/2011
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Last Update Date | 10/31/2011
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Provider Practice Location Address
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Address Line | 9338 AMES HOLLOW RD
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City | CHARLOTTE
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State | NC
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Zip | 28216-8787
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Country | US
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Telephone | 704-509-4540
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 681954
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City | CHARLOTTE
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State | NC
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Zip | 28216-0032
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Country | US
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Telephone | 704-509-4540
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | MRS. KIM RENAE ENGLISH
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Credential | FNP
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Telephone | 704-509-4540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning 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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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