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Individual

MRS. KRISTA LEBRON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1100 BLYTHE BLVD, CHARLOTTE, NC 28203-5814
(704) 355-9458
(704) 355-4002
Mailing address
PO BOX 601372, CHARLOTTE, NC 28260-1372
(704) 355-9458
(704) 355-4002

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
18431
SC
363LF0000X
Family Nurse Practitioner
Primary
263680
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1922429000
NC
05
NP2807
SC
Enumeration date
12/17/2013
Last updated
08/07/2014
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