Provider Demographics
NPI:1063694172
Name:COUTS, MARIA M (NP)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:M
Last Name:COUTS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3333 WILKINSON BLVD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-5631
Mailing Address - Country:US
Mailing Address - Phone:704-393-7720
Mailing Address - Fax:704-398-3173
Practice Address - Street 1:3333 WILKINSON BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-5631
Practice Address - Country:US
Practice Address - Phone:704-393-7720
Practice Address - Fax:704-398-3173
Is Sole Proprietor?:No
Enumeration Date:2007-11-30
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5003514363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner