Organization
BLISS HOME BASED PRIMARY MEDICAL CARE
Active
Other names
BLISS HOME BASED PRIMARY MEDICAL CARE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RENAE WALTON FNP (DNP, FNP-BC, APRN)
(980) 730-2307
Entity
Organization
Contact information
Practice address
1213 W MOREHEAD ST FL 5, CHARLOTTE, NC 28208-5576
(980) 730-2307
(980) 730-2308
Mailing address
1213 W MOREHEAD ST FL 5, CHARLOTTE, NC 28208-5576
(980) 730-2307
(980) 730-2308
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7004187
—
NC
Enumeration date
01/31/2022
Last updated
01/27/2025
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