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Individual

MRS. JACQUELINE ANNETTE SROKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(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
363LF0000X
Family Nurse Practitioner
Primary
204903
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7005234
NC
05
NP1574
SC
Enumeration date
11/30/2009
Last updated
05/07/2012
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