Provider Demographics
NPI:1215762562
Name:AZALI, LELIA G
Entity type:Individual
Prefix:MRS
First Name:LELIA
Middle Name:G
Last Name:AZALI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 481704
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-5330
Mailing Address - Country:US
Mailing Address - Phone:980-384-5999
Mailing Address - Fax:980-890-9792
Practice Address - Street 1:9347 WHITE ASPEN PL
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-1585
Practice Address - Country:US
Practice Address - Phone:980-384-5999
Practice Address - Fax:980-890-9792
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC574757376K00000X
NC102864376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide