MEDICARE: KYLIE BROWN LINDBERG FNP

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	163W00000X	Registered Nurse	288336	NC
2	363LF0000X	Family Nurse Practitioner	5020592	NC

General Provider Information

NPI Number	:	1275305567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLIE BROWN LINDBERG FNP

Provider Business Mailing Address
First Line	:	9745 WHITEWOOD TRL
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-0431
Country	:	US
Telephone Number	:	443-820-6964
Fax Number	:

Provider Business Practice Location Address
First Line	:	7940 WILLIAMS POND LN STE 100
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-8410
Country	:	US
Telephone Number	:	704-752-7779
Fax Number	:

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

Provider Enumeration Date	:	10/30/2023
Last Update Date	:	08/07/2024

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