STACEY C BOHM


Address: 15720 Brixham Hill Ave Ste 130, Charlotte, NC 28277-4784
Phone: 7045415555

STACEY C BOHM (NPI# 1508484031) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1508484031
Entity Type Individual
Full Name STACEY C BOHM
Credential AGACNP-BC
Practice Address 15720 Brixham Hill Ave Ste 130
Charlotte
NC 28277-4784
Practice Telephone 7045415555
Mailing Telephone 7045415555
Enumeration Date 2020-07-10
Last Update Date 2020-07-10
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363LA2100X Nurse Practitioner
Specialization: Acute Care
0024179203 VA Physician Assistants & Advanced Practice Nursing Providers
Y 363LA2100X Nurse Practitioner
Specialization: Acute Care
5013293 NC Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 15720 BRIXHAM HILL AVE STE 130
City CHARLOTTE
State NC
Zip Code 28277-4784

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NPI Name Taxonomy Address Enumeration
1124636667 Select Health Pain and Regenerative Medicine PC Nurse Practitioner 15720 Brixham Hill Ave Ste 130, Charlotte, NC 28277-4784 2020-07-21

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Taxonomy Information

Taxonomy Code 363LA2100X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Acute Care

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1316544927 Christine Marie Davis Nurse Practitioner 1010 Kenilworth Ave Apt 426, Charlotte, NC 28204-3475 2020-10-06
1841891033 Amber Maurer Ettell Nurse Practitioner 125 Queens Rd Ste 420, Charlotte, NC 28204-3215 2020-11-04
1962015420 Randall Lee Coffman Nurse Practitioner 200 Hawthorne Ln, Charlotte, NC 28204-2515 2020-08-25
1699388116 Cassandra L. Barnes Nurse Practitioner 1000 Blythe Blvd, Charlotte, NC 28203-5812 2020-08-25
1407469927 Lesley Rummage Nurse Practitioner 1000 Blythe Blvd, Charlotte, NC 28203-5812 2020-08-25
1437771557 Danielle Margaret Altieri Nurse Practitioner 1010 Edgehill Rd N, Charlotte, NC 28207-1885 2020-05-12
1689207185 Advanced Comprehensive Care Pllc Nurse Practitioner 11301 Golf Links Dr N, Charlotte, NC 28277-8013 2020-02-13
1205476843 Douglas Lowe Nurse Practitioner 200 Hawthorne Ln, Charlotte, NC 28204-2515 2020-01-12
1063963866 Jessica Puskarich Nurse Practitioner 1718 E 4th St, Suite 307, Charlotte, NC 28204-3261 2016-10-18
1174931034 Brandlyn Noftsger Nurse Practitioner 3030 Randolph Rd, Charlotte, NC 28211-1368 2014-07-23
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Competitor

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City CHARLOTTE
Zip Code 28277

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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