Individual
MRS. ANNIE LAURIE LEBOUTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 HAWTHORNE LN, CHARLOTTE, NC 28204-2515
(704) 491-1924
Mailing address
1415 MAIN ST, CHARLOTTE, NC 28204-3145
(225) 281-7429
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
113614
NC
Other
Enumeration date
01/25/2017
Last updated
10/14/2021
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