Individual
LISBETH DAVILA MIJANGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4503 OLD MONROE RD, INDIAN TRAIL, NC 28079-5309
(980) 993-7100
Mailing address
4503 OLD MONROE RD, INDIAN TRAIL, NC 28079-5309
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5018961
NC
Other
Enumeration date
10/10/2023
Last updated
10/10/2023
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