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Individual

ASHLEY IDIAQUEZ KINNAIRD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
2100 STANTONSBURG RD, GREENVILLE, NC 27834-2818
(252) 847-5473
(252) 847-8353
Mailing address
2100 STANTONSBURG RD, GREENVILLE, NC 27834-2818
(252) 847-5473
(252) 847-8353

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5005528
NC
363LA2200X
Adult Health Nurse Practitioner
Primary
5005528
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5005528
NC BOARD OF NURSING: ANP LICENSE
NC
Enumeration date
06/03/2011
Last updated
01/11/2022
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