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NPI Code Detail

MEDICARE: EILEEN MARIE QUILTY NP

MEDICARE: EILEEN MARIE QUILTY 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
1363L00000XNurse Practitioner0006-00036NC
2207Q00000XFamily Medicine Physician600036NC

General Provider Information

NPI Number : 1891773008
Entity Type Code : Individual
Provider Name (Legal Business Name) : EILEEN MARIE QUILTY NP
Provider Business Mailing Address
First Line : 10320 FELD FARM LN STE 300
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-8484
Country : US
Telephone Number : 704-541-0925
Fax Number : 704-541-0924
Provider Business Practice Location Address
First Line : 2645 MERIDIAN PKWY STE 323
Second Line :
City : DURHAM
State : NC
Zip : 27713-4232
Country : US
Telephone Number : 984-227-8902
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2006
Last Update Date : 05/28/2020

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