Individual
KAVONNE Y PRIMOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
U
Credential
RN
Contact information
Practice address
C-1722 TAGATAY DRIVE, FORT LIBERTY, NC 28310-0001
(910) 907-7736
Mailing address
3429 BURBERRY DR, FAYETTEVILLE, NC 28306-6204
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
0001197695
VA
Other
Enumeration date
01/28/2025
Last updated
01/28/2025
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