Imperial Health Services Llc | |
707 S Main St Kannapolis NC 28081 | |
(704) 617-2242 | |
Not Available |
Full Name | Imperial Health Services Llc |
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Speciality | Nurse Practitioner |
Location | 707 S Main St, Kannapolis, North Carolina |
Authorized Official Name and Position | Paula L Dixon (FAMILY NURSE PRACTITIONER) |
Authorized Official Contact | 7046172242 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Imperial Health Services Llc 707 S Main St Kannapolis NC 28081-4915 Ph: (704) 617-2242 | Imperial Health Services Llc 707 S Main St Kannapolis NC 28081 Ph: (704) 617-2242 |
NPI Number | 1629504949 |
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Provider Enumeration Date | 05/05/2017 |
Last Update Date | 05/22/2019 |
Medicare PECOS PAC ID | 4183951072 |
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Medicare Enrollment ID | O20190815001622 |
Identifier | Type | State | Issuer |
---|---|---|---|
1629504949 | NPI | - | NPPES |
7006567 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (North Carolina) | Secondary |
363LF0000X | Nurse Practitioner - Family | 206898 (North Carolina) | Primary |
Provider Name | Paula Leshae Dixon |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1336491885 PECOS PAC ID: 8022261775 Enrollment ID: I20130109000414 |
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