Individual
ELISA EDGERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1142 N BROOME ST, WAXHAW, NC 28173-9378
(704) 843-4680
Mailing address
2832 BUMBLE BEE DR, MATTHEWS, NC 28105-0361
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5006526
NC
Other
Enumeration date
10/14/2013
Last updated
10/14/2013
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