Individual
MS. LISA INELL LARGENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
991 W HUDSON BLVD, GASTONIA, NC 28052-6430
(704) 853-5300
(704) 853-6194
Mailing address
991 W HUDSON BLVD, GASTONIA, NC 28052-6430
(704) 853-5300
(704) 853-6194
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
900434
NC
363LW0102X
Women's Health Nurse Practitioner
Primary
184436
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
184436
RN NUMBER
NC
01
—
900434
MEDICAL BOARD NUMBER
NC
Enumeration date
09/05/2006
Last updated
02/03/2015
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