Waller, Carly Lynne

Waller, Carly Lynne is an individual health care provider with primary practice located at 9955 Poplar Tent Rd , Concord NC 28027-9314. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Waller, Carly Lynne can be contacted via phone (704) 316-4828.

Contact Information

Primary practice address
9955 Poplar Tent Rd Concord NC 28027-9314
Phone: (704) 316-4828
Fax: (704) 316-4829
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X CNM699 North Carolina

Profile Details

NPI number 1649765389
LBN Legal business name Waller, Carly Lynne
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2018
Last updated Jun 30th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649765389 NPPES
North Carolina Other CNM04927 MIDWIFERY JOINT COMMITTEE OF THE STATE OF NORTH CAROLINA

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