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MISTEE LARO FORMICA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
106 LANGTREE VILLAGE DR STE 200, MOORESVILLE, NC 28117-7594
(704) 316-4830
(704) 316-4831
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447

Taxonomy

Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
431
NC
367A00000X
Advanced Practice Midwife
APRN11026120
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7002155
NC
Enumeration date
06/10/2008
Last updated
01/19/2026
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