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Individual

CAROL WOMBLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
6161 LAKE BRANDT RD, GREENSBORO, NC 27455-8414
(336) 643-5800
(336) 643-7474
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 643-5800
(336) 643-7474

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
201015
NC
363LF0000X
Family Nurse Practitioner
000201015
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7005697
NC
Enumeration date
11/02/2006
Last updated
06/21/2013
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