Individual
NICOLE ANNA DESANTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
104 KNOX CT, DAVIDSON, NC 28036-0590
(704) 892-5454
Mailing address
PO BOX 4329, DAVIDSON, NC 28036-4329
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2023-01622
NC
Other
Enumeration date
03/27/2020
Last updated
06/30/2023
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