Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Gerontology
Enumerated
Aug 30, 2023
License(s)
5019337 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 540 YAUGH STREET | Jefferson, NC 28640 | 336-246-5581 |
| MAILING | PO BOX 132 | Trade, TN 37691-0132 | 239-290-0526 |
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