Individual
NINA LISETTE DE VILMORIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10415 WALLACE ALLEY ST, KINGSPORT, TN 37663-3936
(423) 390-0451
Mailing address
PO BOX 603366, CHARLOTTE, NC 28260-3366
(240) 566-1600
(240) 566-1605
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
148229
MT
207L00000X
Anesthesiology Physician
2015-01341
NC
207L00000X
Anesthesiology Physician
Primary
74578
TN
Other
Enumeration date
06/06/2006
Last updated
08/04/2025
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