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Individual

LASHAUNDA RAE MCCLARTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-8000
Mailing address
PO BOX 535395, ATLANTA, GA 30353-5321
(919) 350-8000

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201228
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
201228
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8054083
NC
Enumeration date
06/07/2011
Last updated
03/14/2012
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