Individual
KISUK A TWOGOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
1350 S KINGS DR, CHARLOTTE, NC 28207-2134
(704) 446-1242
(704) 446-1241
Mailing address
PO BOX 601372, CHARLOTTE, NC 28260-1372
(704) 446-1242
(704) 446-1241
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
210851
NC
363L00000X
Nurse Practitioner
5002185
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7003863
—
NC
05
—
NP1573
—
SC
Enumeration date
09/19/2006
Last updated
07/29/2013
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