Individual
ALESHA NICOLE LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1895 HOFFMAN RD STE A, GASTONIA, NC 28054
(704) 865-1749
(704) 865-7328
Mailing address
1895 HOFFMAN RD STE A, GASTONIA, NC 28054-6557
(704) 865-1749
(704) 865-7328
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
233239
NC
363LF0000X
Family Nurse Practitioner
71005545A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201300410
—
IN
01
—
P01512421
RR MEDICARE
IN
Enumeration date
07/09/2015
Last updated
05/30/2019
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