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Individual

MS. SUSAN MISKOVICH MEHTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
219 LEPHILLIP COURT NE, CONCORD, NC 28025-2900
(704) 403-7770
(704) 403-7779
Mailing address
219 LEPHILLIP COURT NE, CONCORD, NC 28025-2900
(704) 403-7770
(704) 403-7779

Taxonomy

Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
076981
NC
363LA2200X
Adult Health Nurse Practitioner
Primary
67386
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
232009
MEDICARE PTAN, GROUP CMCNE
NC
Enumeration date
11/03/2005
Last updated
03/28/2012
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