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Individual

LISA M. DELACRUZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PNP

Contact information

Practice address
14215 BALLANTYNE CORPORATE PL, SUITE 130, CHARLOTTE, NC 28277-3670
(704) 384-1950
(704) 384-1955
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-1440
(704) 384-1452

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5006132
NC
363LP0200X
Pediatric Nurse Practitioner
20122290
OH

Other

Enumeration date
12/18/2012
Last updated
10/28/2020
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