Individual
ELISA SELF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPM
Contact information
Practice address
11834 CARMEL LAKES DR, CHARLOTTE, NC 28226-3603
(704) 497-1215
Mailing address
11834 CARMEL LAKES DR, CHARLOTTE, NC 28226-3603
(704) 497-1215
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
—
—
Other
Enumeration date
02/26/2018
Last updated
02/26/2018
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