Individual
MS. ATHENA MARKELLA KORTESIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
10620 PARK RD, SUITE 128, CHARLOTTE, NC 28210-0106
(704) 542-6111
(704) 542-1239
Mailing address
10620 PARK RD, SUITE 128, CHARLOTTE, NC 28210-0106
(704) 542-6111
(704) 542-1239
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
5004285
NC
363LF0000X
Family Nurse Practitioner
Primary
5004285
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00813835
RAIL ROAD MEDICARE
—
Enumeration date
02/11/2009
Last updated
04/07/2011
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