Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 930230 | NC |
N | 363LN0000X | Nurse Practitioner - Neonatal | 930137 | NC |
NPI | 1164625364 |
---|---|
Provider Name | Lisa E. Garzoni |
First Address | Charlotte, NC 28260-0447 |
Second Address | Charlotte, NC 28204-2515 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2007 |
Last Update Date | 29/10/2020 |