Individual
MRS. MACKENZIE GROMLOVITS CARRIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
501 OLDE WATERFORD WAY, LELAND, NC 28451-4117
(910) 408-1130
(910) 408-1135
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5015901
NC
363LF0000X
Family Nurse Practitioner
5015901
NC
Other
Enumeration date
03/21/2022
Last updated
05/12/2022
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