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1194789784
TAWANNA LATRICE HAIRSTON
WINSTON SALEM, NC
NPI
1194789784
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner, Adult Health
(Licence: NC 900449)
Enumeration Date
2006-04-12
Last Update Date
2012-11-02
Business Address
Ms. TAWANNA LATRICE HAIRSTON ANP
MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157-0001
Phone number: 336-716-2255
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Mailing Address
Ms. TAWANNA LATRICE HAIRSTON ANP
PO BOX 602658
CHARLOTTE, NC 28260-2658
Phone number: 336-716-2255
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