Individual
HALEY MOUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3711 ELMSLEY ST STE 102, GREENSBORO, NC 27406-7039
(336) 890-2200
Mailing address
3711 ELMSLEY ST STE 102, GREENSBORO, NC 27406-7039
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5014659
NC
Other
Enumeration date
07/05/2021
Last updated
10/16/2022
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