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NPI Code Detail

MEDICARE: KIRA MOLLENKOPF SEGEBARTH RD, CPNP

MEDICARE: KIRA MOLLENKOPF SEGEBARTH RD, CPNP
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
1363LP0200XPediatric Nurse Practitioner5005172NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295027845
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIRA MOLLENKOPF SEGEBARTH RD, CPNP
Provider Business Mailing Address
First Line : 1900 VERNON DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28211-1720
Country : US
Telephone Number : 704-960-9178
Fax Number :
Provider Business Practice Location Address
First Line : 201 QUEENS RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28204-3217
Country : US
Telephone Number : 704-316-5910
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2011
Last Update Date : 10/02/2025

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