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NPI Code Detail

MEDICARE: MRS. ASHLEY BORCK KRUSINSKI NP-C

MEDICARE: MRS. ASHLEY BORCK KRUSINSKI NP-C
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
1363LF0000XFamily Nurse Practitioner5006064NC

General Provider Information

NPI Number : 1861731762
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ASHLEY BORCK KRUSINSKI NP-C
Provider Business Mailing Address
First Line : 9310 DEER SPRING LN
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-8020
Country : US
Telephone Number : 803-338-1030
Fax Number :
Provider Business Practice Location Address
First Line : 9915 PARK CEDAR DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-8905
Country : US
Telephone Number : 704-544-3263
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2013
Last Update Date : 01/06/2020

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