Individual
JUDITH PRAIRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
653 BLUEFIELD ROAD, STE F, MOORESVILLE, NC 28117
(704) 360-6480
(704) 883-3228
Mailing address
PO BOX 896199, CHARLOTTE, NC 28289-6199
(833) 936-1364
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2021-00708
NC
Other
Enumeration date
04/02/2018
Last updated
01/12/2022
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