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Organization
INTEGRATED PRIMARY CARE AND BEHAVIORAL HEALTH SERVICES
Active
Organization
INTEGRATED PRIMARY CARE AND BEHAVIORAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAWANDA BOSTIC DNP,PMHNP-BC, FNP-BC (OWNER)
(704) 322-4699
Entity
Organization
Contact information
Practice address
6201 FAIRVIEW RD, SUITE 200, CHARLOTTE, NC 28210-3289
(704) 322-4699
(704) 992-9546
Mailing address
6201 FAIRVIEW RD, SUITE 200, CHARLOTTE, NC 28210-3289
(704) 322-4699
(704) 992-9546
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
196483
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
196483
NC
Other
Enumeration date
02/10/2015
Last updated
03/30/2015
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