Individual
ROKSOLANA STARODUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1350 S KINGS DR, CHARLOTTE, NC 28207-2134
(704) 631-0002
Mailing address
1350 S KINGS DR, CHARLOTTE, NC 28207-2134
(704) 631-0002
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
284130
NC
363LA2100X
Acute Care Nurse Practitioner
SP010110
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336385855
—
NC
05
—
NP3849
—
SC
Enumeration date
01/06/2009
Last updated
11/11/2016
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