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1619110418
LYSA LONG
CHARLOTTE, NC
NPI
1619110418
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
367A00000X Advanced Practice Midwife
(Licence: NC 185)
Enumeration Date
2009-04-09
Last Update Date
2020-10-25
Business Address
LYSA LONG CNM
5933 BLAKENEY PARK DR STE 100
CHARLOTTE, NC 28277-5713
Phone number: 704-316-2021
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Mailing Address
LYSA LONG CNM
PO BOX 60447
CHARLOTTE, NC 28260-0447
Phone number: 704-316-2025
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