Organization
EVENTUS WH MIDWEST CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER RUCCI MD (OWNER)
(512) 792-4402
Entity
Organization
Contact information
Practice address
101 CABARRUS AVE E STE 100, CONCORD, NC 28025-3781
(855) 743-2247
Mailing address
PO BOX 1431 DEPT 425, CHARLOTTE, NC 28201-1431
(855) 743-2247
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/19/2024
Last updated
09/30/2024
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