Individual
NANCY PUTNAM JOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-C
Contact information
Practice address
711 N DEKALB ST, SHELBY, NC 28150-3911
(704) 482-1482
(704) 480-6012
Mailing address
711 N DEKALB ST, SHELBY, NC 28150-3911
(704) 482-1482
(704) 480-6012
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
900397
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8958513
—
NC
Enumeration date
08/31/2005
Last updated
03/21/2011
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