Individual
KRISHNA KOTHARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
301 LLOYD ST, CARRBORO, NC 27510-1823
(919) 942-1473
Mailing address
301 LLOYD ST, CARRBORO, NC 27510-1823
(919) 942-8741
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
106073
CT
163W00000X
Registered Nurse
124382
IA
363LF0000X
Family Nurse Practitioner
005150
CT
363LP2300X
Primary Care Nurse Practitioner
Primary
5010747
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004236346
—
CT
Enumeration date
08/14/2012
Last updated
08/21/2019
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