Individual
KELLI DENISE LANIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
200 MEDICAL PARK DR, STE 550B, CONCORD, NC 28025-2982
(704) 403-9177
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5012835
NC
363LA2100X
Acute Care Nurse Practitioner
5012835
NC
Other
Enumeration date
11/11/2019
Last updated
07/24/2024
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