Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
Jan 19, 2007
License(s)
SP008019 (PA), 5004102 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 46 KINGLET CIR | Greensboro, NC 27455-1362 | 336-285-8599 |
| LOCATION | 3803 N ELM ST | Greensboro, NC 27455-2593 | 336-541-0778 |
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