Individual
NOLI PUNZALAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2153 VALLEYGATE DR STE 102, FAYETTEVILLE, NC 28304-3667
(910) 321-7246
Mailing address
2153 VALLEYGATE DR STE 102, FAYETTEVILLE, NC 28304-3667
(910) 321-7246
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5010836
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
NC
Enumeration date
08/14/2018
Last updated
08/14/2018
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