Provider Demographics
NPI:1326877572
Name:KASEMBWE, TSHIKWAKWA (FNP-BC)
Entity type:Individual
Prefix:
First Name:TSHIKWAKWA
Middle Name:
Last Name:KASEMBWE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:537 WEST SUGAR CREEK RD # 201
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213
Mailing Address - Country:US
Mailing Address - Phone:704-222-5528
Mailing Address - Fax:
Practice Address - Street 1:537 W SUGAR CREEK RD STE 201
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-6103
Practice Address - Country:US
Practice Address - Phone:704-979-8210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-27
Last Update Date:2024-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5020526363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner