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Individual
MRS. PHYLLIS T. KUPSICK
Active
Individual
MRS. PHYLLIS T. KUPSICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201184
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0105E
BLUE CROSS BLUE SHIELD
NC
05
—
8984978
—
NC
Enumeration date
01/19/2006
Last updated
10/10/2014
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