Individual
LACOSTA TIPTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
202 MEDICAL CAMPUS DR, YCHD, BURNSVILLE, NC 28714-9004
(828) 682-6118
(828) 682-6262
Mailing address
202 MEDICAL CAMPUS DR, YCHD, BURNSVILLE, NC 28714-9004
(828) 682-6118
(828) 682-6262
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
223207
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
223207
STATE LICENSE
NC
Enumeration date
04/26/2010
Last updated
04/26/2010
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