Individual
MARA E KEITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
8401 MEDICAL PLAZA DR, STE 365, CHARLOTTE, NC 28262-8797
(704) 944-0975
(704) 943-3699
Mailing address
8401 MEDICAL PLAZA DR, STE 365, CHARLOTTE, NC 28262-8797
(704) 944-0975
(704) 943-3699
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5007439
NC
Other
Enumeration date
01/22/2015
Last updated
02/03/2016
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