Individual
MRS. HAYLEY HASTY LESUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11840 SOUTHMORE DR STE 100, CHARLOTTE, NC 28277-4821
(980) 308-0169
(980) 308-0173
Mailing address
PO BOX 601843, CHARLOTTE, NC 28260-1843
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-01931
NC
363A00000X
Physician Assistant
005603
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0828PA
—
SC
Enumeration date
04/06/2009
Last updated
05/06/2024
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