Individual
MS. LAURA JEAN KISTLER TETTERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
508 FULTON ST, SURGICAL SERVICES (112), DURHAM, NC 27705-3875
(919) 416-5867
Mailing address
PO BOX 3507, ERWIN ROAD, DURHAM, NC 27710-0001
(919) 684-4117
(919) 681-8563
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
084764
NC
Other
Enumeration date
06/23/2008
Last updated
06/23/2008
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