Provider Demographics
NPI:1962108134
Name:KAMINSKY, BEGONA CECILIA (FNP)
Entity type:Individual
Prefix:
First Name:BEGONA
Middle Name:CECILIA
Last Name:KAMINSKY
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2950 PINE PLANTATION PKWY
Practice Address - Street 2:
Practice Address - City:BLNG SPG LKS
Practice Address - State:NC
Practice Address - Zip Code:28461-0119
Practice Address - Country:US
Practice Address - Phone:910-454-4032
Practice Address - Fax:910-454-3033
Is Sole Proprietor?:No
Enumeration Date:2023-01-31
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5017597363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC249216OtherRN LICENSE
NC5017597OtherFNP LICENSE