Registry details
Type
Individual
Primary specialty
Nurse Practitioner
Enumerated
Sep 15, 2016
License(s)
5008931 (NC)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 60447 | Charlotte, NC 28260-0447 | |
| LOCATION | 106 CORPORATE PARK DR STE 200&300 | Mooresville, NC 28117-7133 | 704-235-9090 |
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