DECOYA YAHTES BLUE
Individual Provider (NPI-1)
Active
Nurse Practitioner, Pediatrics
Provider Information
- NPI Number
1770365397- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 66 LAKE CONCORD RD NE, CONCORD, NC, 280253057
- Phone
- (704) 403-7720
Specialties & Taxonomies
Nurse Practitioner, Pediatrics
Primary License: NC #5019014
All Addresses
MAILING
66 LAKE CONCORD RD NE
CONCORD, NC, 280253057