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General NPI Number Information
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NPI Number | 1649101429
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Entity Type | Organization
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Legal Business Name | PORCIA MICHELLE LASTER LLC
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Dates
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Enumeration Date | 05/28/2026
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Last Update Date | 05/28/2026
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Provider Practice Location Address
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Address Line | 2030 STRICKLAND OAK WAY
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City | DURHAM
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State | NC
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Zip | 27703-6818
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Country | US
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Telephone | 984-222-4924
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Fax |
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Provider Business Mailing Address
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Address Line | 2030 STRICKLAND OAK WAY
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City | DURHAM
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State | NC
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Zip | 27703-6818
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Country | US
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Telephone | 984-222-4924
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MISS PORCIA MICHELLE LASTER
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Credential | RN
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Telephone | 984-222-4924
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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