Individual
MRS. TENEIKA CLIFTON FUNDERBURK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6033 FLORENCE AVE STE 200, CHARLOTTE, NC 28212
(980) 430-5055
(704) 749-8652
Mailing address
6033 FLORENCE AVE STE 200, CHARLOTTE, NC 28212-6390
(980) 430-5055
(704) 749-8652
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
HC3403
NC
3747P1801X
Personal Care Attendant
Primary
HC3403
NC
376K00000X
Nurse's Aide
329836
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6601520
—
NC
Enumeration date
07/08/2007
Last updated
01/31/2019
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