MEDICARE: KRIS KATHERINE SEAGLE

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	363L00000X	Nurse Practitioner	5023462	NC

General Provider Information

NPI Number	:	1457211963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRIS KATHERINE SEAGLE

Provider Business Mailing Address
First Line	:	2512 AUSTYN JOEY DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28214-9713
Country	:	US
Telephone Number	:	704-446-9991
Fax Number	:

Provider Business Practice Location Address
First Line	:	2512 AUSTYN JOEY DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28214-9713
Country	:	US
Telephone Number	:	704-446-9991
Fax Number	:

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

Provider Enumeration Date	:	11/17/2025
Last Update Date	:	02/10/2026

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Directions to “ KRIS KATHERINE SEAGLE ” Practice Location

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