Registry details
Type
Individual
Primary specialty
Nurse Practitioner
Enumerated
Jun 27, 2025
License(s)
5022737 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 60447 | Charlotte, NC 28260-0447 | 704-384-0588 |
| LOCATION | 6324 FAIRVIEW RD STE 201 | Charlotte, NC 28210-4278 | 704-384-0588 |
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