Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
Nov 10, 2014
License(s)
9324695 (FL), 5011232 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 13304 LEESVILLE CHURCH RD | Raleigh, NC 27617-5206 | 386-679-2956 |
| MAILING | 13304 LEESVILLE CHURCH RD | Raleigh, NC 27617-5206 | 866-389-2727 |
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