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Mrs. Justine Koerner Tye, CPNP
Pediatric Nurse Practitioner in Charlotte, North Carolina
NPI 1366724098

Justine Koerner Tye is a Pediatric Nurse Practitioner based in Charlotte, NC and is specialized in Pediatrics. Justine Koerner Tye practices in Charlotte, NC and has the professional credentials of CPNP. The NPI Number for Justine Koerner Tye is 1366724098 and holds a License No. 5005317 (North Carolina).

The current practice location address for Justine Koerner Tye is 1350 S Kings Dr, Charlotte, NC and can be reached out via phone at 704-446-1422 and via fax at 704-446-1582.

Location: 1350 S Kings Dr, Charlotte, NC, 28260-1372
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Provider Profile Details
NPI Number
1366724098
Provider Name
Justine Koerner Tye
Credential
CPNP
Provider Entity Type
Individual
Gender
Female
Address
1350 S Kings Dr, Charlotte, NC, 28260-1372
Phone Number
704-446-1422
Fax Number
704-446-1582
Provider Enumeration Date
09/20/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1366724098 05 NC
NP2580 05 SC
1558308080 05 NC
institution
Provider Business Practice Location Address Details
Address
1350 S Kings Dr
City
State
Zip
28207-2134
Phone Number
704-446-1422
Fax Number
704-446-1582
person
Provider Business Mailing Address Details
Address
1350 S Kings Dr
City
State
Zip
28207-2134
Phone Number
704-446-1422
Fax Number
704-446-1582
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
License No.
5005317 (North Carolina)
Definition
Definition to come...
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