Individual
LORY ELIZABETH PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
600 CHATHAM MEDICAL PARK, ELKIN, NC 28621-2482
(336) 835-4819
Mailing address
600 CHATHAM MEDICAL PARK, ELKIN, NC 28621-2482
(336) 835-4819
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
224506
NC
Other
Enumeration date
10/10/2012
Last updated
10/22/2012
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