Provider Demographics
NPI:1568546059
Name:BYCROFT, JANE (FNP)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:
Last Name:BYCROFT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1300 BAXTER ST STE 215
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-3106
Mailing Address - Country:US
Mailing Address - Phone:704-332-0366
Mailing Address - Fax:704-971-0035
Practice Address - Street 1:1640 CAMPUS PARK DR
Practice Address - Street 2:SUITE C
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-5283
Practice Address - Country:US
Practice Address - Phone:704-226-0366
Practice Address - Fax:704-226-9535
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5001136363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7003890Medicaid
NC7003890Medicaid