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General NPI Number Information
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NPI Number | 1992683312
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Entity Type | Organization
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Legal Business Name | BESPOKE RN, PLLC
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 234 LACEWING DR
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City | CHARLOTTE
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State | NC
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Zip | 28214-0168
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Country | US
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Telephone | 910-228-1215
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Fax |
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Provider Business Mailing Address
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Address Line | 234 LACEWING DR
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City | CHARLOTTE
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State | NC
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Zip | 28214-0168
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Country | US
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Telephone | 910-228-1215
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Fax |
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Authorized Official
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Title or Position | CO- FOUNDER/NURSE
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Name | DANITA MCKOY
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Credential | RN- BSN
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Telephone | 910-228-1215
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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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 | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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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 | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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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 | 163WP0000X
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Taxonomy Name | Pain Management Registered Nurse
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 163WS0121X
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Taxonomy Name | Plastic Surgery Registered Nurse
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 163WX0800X
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Taxonomy Name | Orthopedic Registered Nurse
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number |
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License Number State |
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