Doctor Name: | MRS. PHYLLIS T. KUPSICK |
NPI Number: | 1033199682 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | 201184 |
Business Practice Address: | 313 Yadkin St Albemarle, NC - 280013441 |
Business Phone Number: | 7049844388 |
Business Fax Number: | 7049844132 |
Mailing Address: | 320 Yadkin St, Suite B ALBEMARLE |
State: | NC |
Postal Code: | 280013447 |
Phone Number: | 7049837320 |
Fax Number: | 7049836153 |
NPI Enumeration Date: | 01/19/2006 |
NPI Last Update Date: | 10/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 201184 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |