Individual
MARY KAY HOSTETLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NNP
Contact information
Practice address
2100 STANTONSBURG RD, GREENVILLE, NC 27834-2818
(252) 847-4113
(252) 847-9946
Mailing address
2223 LOCKSLEY WOODS DR, UNIT #H, GREENVILLE, NC 27858-5455
(252) 355-5720
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
137721
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NNP
LICENSE
NC
Enumeration date
01/10/2007
Last updated
07/08/2007
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