Individual
LISA JERVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
125 QUEENS RD STE 500, CHARLOTTE, NC 28204-3215
(980) 302-6380
(980) 302-6385
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(980) 302-6380
(980) 302-6385
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
9900072
NC
Other
Enumeration date
07/19/2006
Last updated
08/18/2021
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