Individual
LISVEL MATOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
249 BILLINGSLEY RD, CHARLOTTE, NC 28211-1003
(980) 314-9138
Mailing address
249 BILLINGSLEY RD, CHARLOTTE, NC 28211-1003
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
5009422
NC
Other
Enumeration date
04/20/2017
Last updated
04/20/2017
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