Individual
MARK CURRY MAYNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
125 W ROBIN DR, ADVANCE, NC 27006
(336) 529-0281
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
245287
NC
363L00000X
Nurse Practitioner
Primary
5010267
NC
Other
Enumeration date
11/14/2017
Last updated
10/26/2020
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