VITA FAMILY PRACTICE PLLC NPI 1770004723

NPI Information

NPI: 1770004723
Provider Name: VITA FAMILY PRACTICE PLLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 34D2133177

Address:
609 EXECUTIVE PL STE B
FAYETTEVILLE, NC
ZIP 28305
Phone: (910) 489-3185
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VITA FAMILY PRACTICE PLLC is a primary care clinic center in Fayetteville, NC. VITA FAMILY PRACTICE PLLC NPI is 1770004723. The provider is registered as an organization entity type.

The provider's business location address is:

609 EXECUTIVE PL STE B
FAYETTEVILLE, NC
ZIP 28305-713
Phone: (910) 489-3185

The provider's authorized official is Jennifer I Sturcken .
The authorized official title is Owner and has the following contact phone number (910) 677-9488.

The CLIA number assigned to this NPI record is 34D2133177 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/29/2017 and was last updated on 1/31/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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