Individual
CASEY HIATT IRVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP-BC
Contact information
Practice address
1 MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 713-6428
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5010758
NC
363LN0000X
Neonatal Nurse Practitioner
5010758
NC
363LN0005X
Critical Care Neonatal Nurse Practitioner
245261
NC
Other
Enumeration date
07/05/2018
Last updated
07/24/2024
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