Individual
LATOYA JEANETTE HAIRSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 DEER STAND DR, MADISON, NC 27025-8095
(336) 500-2114
Mailing address
200 DEER STAND DR, MADISON, NC 27025-8095
(336) 500-2114
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
76683
NC
Other
Enumeration date
10/14/2025
Last updated
10/14/2025
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