Individual
NANCY SUSAN DESILLIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
257 HOSPITAL DR NE STE 100, BOLIVIA, NC 28422-8411
(910) 721-4150
(910) 721-4159
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
351739
NC
363L00000X
Nurse Practitioner
Primary
5019582
NC
Other
Enumeration date
02/20/2023
Last updated
04/11/2024
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