Individual
MARIE KRIDER LIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP-PC
Contact information
Practice address
635 N NC 16 BUSINESS HWY, DENVER, NC 28037-7574
(704) 489-8401
Mailing address
3117 WINDSOR DR, CHARLOTTE, NC 28209-3349
(804) 212-8870
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
5015657
NC
Other
Enumeration date
01/25/2022
Last updated
01/25/2022
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