Organization Name: | FALLS PEDIATRICS |
NPI Number: | 1609243799 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ELIZABETH CALDWELL (FNP) |
Mailing Address: | 4355 Hickory Blvd Granite Falls |
State: | NC US |
Postal Code: | 286301992 |
Phone Number: | 8287575050 |
Fax Number: | 8287575051 |
NPI Enumeration Date: | 08/25/2015 |
NPI Last Update Date: | 08/26/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 364SP0200X |
License Number: | CALD-25GVJ6 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Clinical Nurse Specialist |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |