Individual
ALISA C NANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
150 FAIRVIEW RD, SUITE 210, MOORESVILLE, NC 28117-9500
(704) 235-0300
Mailing address
650 SIGNAL HILL DRIVE EXT, PO BOX 1845, STATESVILLE, NC 28625-4353
(704) 873-4277
(704) 873-4511
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9900622
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891197U
—
NC
Enumeration date
11/03/2005
Last updated
01/23/2014
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