Individual
ELIZABETH WARREN DESANDRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
584 HOSPITAL DR NE UNIT D, BOLIVIA, NC 28422-0020
(910) 721-4150
(910) 721-4159
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
272250
NC
363L00000X
Nurse Practitioner
Primary
5014307
NC
Other
Enumeration date
04/09/2021
Last updated
07/14/2021
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