Registry details
Type
Individual
Primary specialty
Nurse Practitioner
Enumerated
Feb 21, 2022
License(s)
5016136 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 60447 | Charlotte, NC 28260-0447 | |
| LOCATION | 200 GREENWICH RD | Charlotte, NC 28211-2316 | 704-384-8680 |
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