Individual
MR. JUSTIN FLETCHER SEGREST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP, MSN, RN
Contact information
Practice address
2770 LEWISVILLE CLEMMONS RD, CLEMMONS, NC 27012-8716
(336) 766-0324
Mailing address
2770 LEWISVILLE CLEMMONS RD, CLEMMONS, NC 27012-8716
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5005952
NC
363LF0000X
Family Nurse Practitioner
Primary
5005952
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477842987
—
NC
Enumeration date
04/05/2011
Last updated
09/28/2017
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