Individual
MRS. BRIELLE MICKELA LEISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10806 MONROE RD, MATTHEWS, NC 28105-7305
(704) 321-5700
Mailing address
10806 MONROE RD, MATTHEWS, NC 28105-7305
(704) 321-5700
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
5019105
NC
Other
Enumeration date
10/30/2023
Last updated
08/04/2024
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