Individual
MIKAYLA JORDAN RAFTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1381 WESTGATE CENTER DR, WINSTON SALEM, NC 27103-2934
(336) 718-0100
(336) 718-0120
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5019171
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/20/2023
Last updated
01/15/2024
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