Individual
LAUREN BROOKE KISER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
1900 RANDOLPH RD STE 1010, CHARLOTTE, NC 28207-1117
(704) 384-1390
(704) 384-1063
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
213186
VA
363L00000X
Nurse Practitioner
Primary
5011049
NC
363LP0200X
Pediatric Nurse Practitioner
5011049
NC
Other
Enumeration date
09/27/2018
Last updated
12/03/2021
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