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NPI Code Detail

MEDICARE: MARIA M. COUTS NP

MEDICARE: MARIA M. COUTS NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner5003514NC

General Provider Information

NPI Number : 1063694172
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA M. COUTS NP
Provider Business Mailing Address
First Line : 3333 WILKINSON BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28208-5631
Country : US
Telephone Number : 704-393-7720
Fax Number : 704-398-3173
Provider Business Practice Location Address
First Line : 3333 WILKINSON BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28208-5631
Country : US
Telephone Number : 704-393-7720
Fax Number : 704-398-3173
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2007
Last Update Date : 02/16/2017

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