Individual
KARISSA M LACLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1200 N ELM ST, GREENSBORO, NC 27401-1004
(336) 832-2527
Mailing address
1200 N ELM ST, GREENSBORO, NC 27401-1004
(336) 832-2527
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5005727
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5005727
NC LICENSE
NC
Enumeration date
07/26/2012
Last updated
07/17/2019
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