Individual
KIRBY BANDOQUILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
135 W 10TH ST, CHARLOTTE, NC 28202-2229
(704) 626-3994
Mailing address
650 S TRYON ST STE 440, CHARLOTTE, NC 28202-3271
(704) 626-6266
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
5018543
NC
Other
Enumeration date
03/31/2015
Last updated
05/01/2025
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