ADULT AND GERIATRIC HEALTHCARE PLLC NPI 1043948482

NPI Information

NPI: 1043948482
Provider Name: ADULT AND GERIATRIC HEALTHCARE PLLC
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Organization

Specialization: Adult Health

CLIA Number: 34D2263988

Address:
325 1ST AVE SW
HICKORY, NC
ZIP 28602
Phone: (828) 228-5326
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ADULT AND GERIATRIC HEALTHCARE PLLC is an adult health nurse practitioner in Hickory, NC. ADULT AND GERIATRIC HEALTHCARE PLLC NPI is 1043948482. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

325 1ST AVE SW
HICKORY, NC
ZIP 28602-940
Phone: (828) 228-5326

The provider's authorized official is Crystal Shuandale Killian .
The authorized official title is Owner and has the following contact phone number (828) 228-5326.

The CLIA number assigned to this NPI record is 34D2263988 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/12/2022 and was last updated on 8/12/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1114493111	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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