Provider Demographics
NPI:1689207185
Name:ADVANCED COMPREHENSIVE CARE PLLC
Entity Type:Organization
Organization Name:ADVANCED COMPREHENSIVE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:BROWN
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:980-280-4010
Mailing Address - Street 1:7123 RAMSGATE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28270-6538
Mailing Address - Country:US
Mailing Address - Phone:980-280-4010
Mailing Address - Fax:
Practice Address - Street 1:11301 GOLF LINKS DR N
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-8013
Practice Address - Country:US
Practice Address - Phone:980-280-4010
Practice Address - Fax:980-280-4011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-13
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Multi-Specialty