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Individual

WANDA A FUSCHINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
349 PENNY LN NE, CONCORD, NC 28025-1221
(704) 786-7158
(704) 784-3307
Mailing address
PO BOX 602148, CHARLOTTE, NC 28260-2148
(704) 786-7158
(704) 784-3307

Taxonomy

Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
940043
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1922106426
NC
05
7006075
NC
Enumeration date
09/20/2006
Last updated
11/30/2016
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