Individual
MRS. JALYSA GAVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
204 MALLOY ST STE A, GOLDSBORO, NC 27534-4477
(919) 751-7665
Mailing address
2905 OAKWOOD DR, WINTERVILLE, NC 28590-8067
(910) 441-8652
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5012334
NC
Other
Enumeration date
09/26/2019
Last updated
09/26/2019
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