Individual
MRS. NICOLE DEGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
9606 BAILEY RD, SUITE 250, CORNELIUS, NC 28031-6109
(704) 896-8868
(704) 896-7975
Mailing address
9606 BAILEY RD, SUITE 250, CORNELIUS, NC 28031-6109
(704) 896-8868
(704) 896-7975
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
9139
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1351C
BLUECROSS BLUESHIELD NC
NC
05
—
7211540
—
NC
01
—
D2145
MEDCOST
NC
Enumeration date
09/25/2006
Last updated
07/08/2007
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