MEDICARE: EUGENIA KES 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
1	363LA2200X	Adult Health Nurse Practitioner	F307743-01	NY

General Provider Information

NPI Number	:	1174342810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EUGENIA KES NP

Provider Business Mailing Address
First Line	:	8515 KIRCHENBAUM DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28210-5858
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 LASH DR
Second Line	:
City	:	SALISBURY
State	:	NC
Zip	:	28147-9151
Country	:	US
Telephone Number	:	704-637-1182
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2024
Last Update Date	:	10/09/2024

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