Individual
LOGAN BALLARD HARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1381 E GARRISON BLVD, GASTONIA, NC 28054-5127
(704) 864-6006
Mailing address
PO BOX 744786, ATLANTA, GA 30374-4786
(704) 913-0514
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5013548
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5013548
NORTH CAROLINA BOARD OF NURSING
NC
Enumeration date
09/14/2020
Last updated
03/02/2023
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