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Individual

KRYSTIN BROOKE HEPBURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGNP-C

Contact information

Practice address
125 QUEENS RD STE 400, CHARLOTTE, NC 28204-3215
(980) 302-6400
(980) 302-6405
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
258915
NC
363LA2200X
Adult Health Nurse Practitioner
258915
NC
363LG0600X
Gerontology Nurse Practitioner
258915
NC

Other

Enumeration date
09/04/2019
Last updated
06/14/2021
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