Individual
MRS. CARLA SAMANTHA VASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
305 E LEE AVE, YADKINVILLE, NC 27055-8132
(336) 679-2661
(336) 679-7056
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
247085
NC
363L00000X
Nurse Practitioner
Primary
5012577
NC
Other
Enumeration date
11/26/2019
Last updated
10/26/2020
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