Individual
LISA GAUSE HARDEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
207 W 29TH ST, LUMBERTON, NC 28358-2901
(910) 618-5606
Mailing address
207 W 29TH ST, LUMBERTON, NC 28358-2901
(910) 618-5606
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
065910
NC
Other
Enumeration date
07/12/2011
Last updated
07/12/2011
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