Most Relevant Information
Provider Data
| NPI Number: | 1003804972 |
| Provider Name: | JONATHAN LABAYO DESAMERO FNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363L00000X |
| Specialty: | Nurse Practitioner |
| License Number: | 201824 |
Most Important Dates
| Enumeration Date: | 10/13/2005 |
| Last Updated: | 07/15/2024 |
Provider Practice Location
3715 UNION RD
GASTONIA
NC
280568044
Practice Location Phone/Fax
| Phone: | 7048548202 |
| Fax: |
Provider Mailing Location
PO BOX 19305
CHARLOTTE
NC
282199305
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |