Individual
JONATHAN LABAYO DESAMERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
3715 UNION RD, GASTONIA, NC 28056-8044
(704) 854-8202
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
201824
NC
363LF0000X
Family Nurse Practitioner
Primary
201824
NC
Other
Enumeration date
10/13/2005
Last updated
07/15/2024
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