Individual
SARAH JORDYN-MARY STREET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
6324 FAIRVIEW RD STE 201, CHARLOTTE, NC 28210-4278
(704) 384-0588
(704) 384-0580
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5021219
NC
363LP2300X
Primary Care Nurse Practitioner
5021219
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/18/2024
Last updated
01/06/2025
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