Organization · NPI-2

Bespoke Rn, PLLC

Registered Nurse, General Practice · Charlotte, NC

NPI number1992683312

StatusActive

Last updated in NPPESAug 25, 2025

Details

NPI: 1992683312
Entity type: Organization (NPI-2)
Legal business name: Bespoke Rn, PLLC
Organization subpart: No
Enumeration date: Aug 25, 2025
Certification date: Aug 24, 2025
Last updated: Aug 25, 2025

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
163WG0000X	Registered Nurse, General Practice	–	–	Yes
163WH0200X	Registered Nurse, Home Health	–	–
163WI0500X	Registered Nurse, Infusion Therapy	–	–
163WL0100X	Registered Nurse, Lactation Consultant	–	–
163WP0000X	Registered Nurse, Pain Management	–	–
163WS0121X	Registered Nurse, Plastic Surgery	–	–
163WW0000X	Registered Nurse, Wound Care	–	–
163WX0800X	Registered Nurse, Orthopedic	–	–

Practice location

234 Lacewing Dr
Charlotte, NC 28214-0168

Phone 910-228-1215

Mailing address

234 Lacewing Dr
Charlotte, NC 28214-0168

Phone 910-228-1215

Authorized official

Danita Mckoy
Co- Founder/Nurse
9102281215

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