Individual
MRS. NICOLE M BENTIVEGNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
3125 SPRINGBANK LN STE A, CHARLOTTE, NC 28226-3379
(704) 752-9346
(704) 943-0641
Mailing address
1245 BROUGH HALL DR, WAXHAW, NC 28173-6937
(804) 814-2483
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
5006674
NC
363LW0102X
Women's Health Nurse Practitioner
0024167921
VA
Other
Enumeration date
07/31/2008
Last updated
06/23/2020
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