Individual
MS. LISA ANN SANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN FNP
Contact information
Practice address
3305 SUNGATE BLVD, RALEIGH, NC 27610-2871
(919) 212-0129
(919) 255-1540
Mailing address
125 TALLY HO DR, SELMA, NC 27576-8451
(919) 965-4459
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
105289
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7000247
—
TX
Enumeration date
01/11/2007
Last updated
03/29/2013
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