Organization
LOTUS CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE MISHONDA BLUE FNP (ADMINISTRATOR)
(910) 719-9134
Entity
Organization
Contact information
Practice address
208 MCKOY ST, CLINTON, NC 28328-3402
(910) 763-7151
(910) 310-4047
Mailing address
208 MCKOY ST, CLINTON, NC 28328-3402
(910) 719-9134
(910) 310-4047
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/25/2022
Last updated
05/16/2022
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