Individual
ELIZABETH REVIS BOONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
124 ROANOKE RD, FLETCHER, NC 28732-7923
(828) 513-8604
Mailing address
124 ROANOKE RD, FLETCHER, NC 28732-7923
(828) 513-8604
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
BOON-V2YUI
NC
Other
Enumeration date
09/27/2022
Last updated
09/27/2022
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