Individual
JUSTICE EDMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
920 CHURCH ST N, CONCORD, NC 28025-2927
(704) 403-3000
Mailing address
3612 WHITEHALL GREEN LN APT 5109, CHARLOTTE, NC 28273-7303
(803) 446-0809
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
149635
NC
Other
Enumeration date
05/31/2024
Last updated
12/05/2024
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