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Individual

LAURA AUTUMN DE LEON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
133 WELTON WAY, SUITE C, MOORESVILLE, NC 28117-9163
(704) 664-2552
(704) 664-5382
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 664-2552
(704) 664-5382

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5006144
NC

Other

Enumeration date
05/02/2009
Last updated
05/08/2024
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