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Individual

MRS. KACIE MINTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C, IBCLC

Contact information

Practice address
50 MILLER ST, SUITE G, WINSTON SALEM, NC 27104-4205
(336) 718-7660
Mailing address
2323 WESTOVER DR, WINSTON SALEM, NC 27103-3646
(336) 816-9701

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
231237
NC
363LF0000X
Family Nurse Practitioner
Primary
231237
NC

Other

Enumeration date
02/06/2017
Last updated
04/05/2022
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