Individual
LAURA W BASTIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4008 CAPITAL DR, ROCKY MOUNT, NC 27804-3123
(252) 937-5003
Mailing address
1821 ERKIN SMITH RD, NASHVILLE, NC 27856-8805
(252) 904-1639
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
147408
NC
Other
Enumeration date
09/25/2023
Last updated
09/25/2023
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