Individual
MISTY LAVERNE MASSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 E WENDOVER AVE, GREENSBORO, NC 27405-6713
(336) 641-6601
Mailing address
552 PERKINSON RD, RUFFIN, NC 27326-9005
(336) 552-3472
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
74046
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
74046
NC BOARD OF NURSING
NC
Enumeration date
08/18/2022
Last updated
08/18/2022
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