Individual
PROF. CAROLYN K. MAYNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD FNP
Contact information
Practice address
1307 S CANNON BLVD, KANNAPOLIS, NC 28083-6232
(704) 920-1000
(704) 920-1366
Mailing address
1252 GIVERNY CT, CONCORD, NC 28027-8130
(704) 788-4347
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
054700
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZF0000099
—
NC
Enumeration date
02/27/2007
Last updated
07/09/2007
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