Individual
MARY WALKER LARACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
2500 SUMMIT AVE, GREENSBORO, NC 27405-4522
(336) 621-2500
(336) 621-4516
Mailing address
2500 SUMMIT AVE, GREENSBORO, NC 27405-4522
(336) 621-2500
(336) 621-4516
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
005000027
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7003698
—
NC
Enumeration date
07/11/2006
Last updated
07/06/2023
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