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Individual

ANNELISE BARBARA YVONNE LANDRETH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, FNP

Contact information

Practice address
4530 FAYETTEVILLE RD, RALEIGH, NC 27603-3614
(919) 235-1930
Mailing address
PO BOX 602195, CHARLOTTE, NC 28260-2195
(919) 350-0351
(919) 350-7687

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5018604
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1790476869
NC
Enumeration date
05/18/2023
Last updated
10/16/2023
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