Individual
MRS. LACI JO VANDERBOEGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, FNP-C
Contact information
Practice address
1700 TARBORO ST W STE 100, WILSON, NC 27893-3481
(252) 399-5314
Mailing address
1103 GREENBRIAR RD NW, WILSON, NC 27896-2146
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5019962
NC
Other
Enumeration date
04/26/2024
Last updated
04/26/2024
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