Individual
MS. MARY KRESHON
Active
Individual
MS. MARY KRESHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
001004757
NC
363AM0700X
Medical Physician Assistant
Primary
52673
CA
363AS0400X
Surgical Physician Assistant
0010-04757
NC
Other
Enumeration date
01/17/2014
Last updated
12/19/2022
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