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Individual

KELLY DAWKINS BUMGARDNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
633 BROOKDALE DR STE 100, STATESVILLE, NC 28677-3471
(704) 873-7850
Mailing address
PO BOX 1845, STATESVILLE, NC 28687-1845
(704) 873-4277

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5015740
NC
363LF0000X
Family Nurse Practitioner
BUMG-XQH6C
NC

Other

Enumeration date
11/09/2021
Last updated
03/03/2022
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