SearchNorth Carolina1041C0700X

De'Voncia Mickins

NPI 1992383103 · on the registry since 2021

Practice

Address
104 E Old Us 74/76
Lake Waccamaw, NC 28450
Phone
(252) 521-0773

Registry record

Primary taxonomy
1041C0700X
1041C0700X
Licence states on file
NC
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2021-03-30

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in North Carolina