Individual
KEISHA LASHAWN SPELLER-PERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2817 ROCK MERRITT AVE, FORT LIBERTY, NC 28310-0001
(910) 396-4307
Mailing address
2817 ROCK MERRITT AVE, FORT LIBERTY, NC 28310-0001
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
186914
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
236
—
DC
01
—
568946544
BCBS
—
01
—
5874
HEALTH PARTNERS
—
Enumeration date
10/02/2024
Last updated
10/02/2024
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