Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Gerontology
Enumerated
Mar 8, 2007
License(s)
2854 (SC), 2854 (SC), 249757 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 602148 | Charlotte, NC 28260-2148 | 704-512-5363 |
| LOCATION | 1000 BLYTHE BLVD | Charlotte, NC 28203-5812 | 704-512-5363 |
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