Individual
JUANITA SHAWNTA OUTLAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
293 BELLA SQ, SMITHFIELD, NC 27577-8961
(252) 724-0192
Mailing address
293 BELLA SQ, SMITHFIELD, NC 27577-8961
(252) 724-0192
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
197527
NC
363LF0000X
Family Nurse Practitioner
5017031
NC
Other
Enumeration date
10/03/2022
Last updated
01/03/2023
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