Individual
KATHLEEN MARIE MISHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
236 MARKET ST STE 110, LOCUST, NC 28097-9439
(704) 384-9590
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
232039
NC
Other
Enumeration date
07/24/2018
Last updated
04/12/2023
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