LIFESOURCE OF NORTH CAROLINA NPI 1386144418

NPI Information

NPI: 1386144418
Provider Name: LIFESOURCE OF NORTH CAROLINA
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
1208 E PERSHING BLVD
CHEYENNE, WY
ZIP 82001
Phone: (910) 742-9243
Get Directions

LIFESOURCE OF NORTH CAROLINA is a general practice in Cheyenne, WY. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee LIFESOURCE OF NORTH CAROLINA NPI is 1386144418. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1208 E PERSHING BLVD
CHEYENNE, WY
ZIP 82001-230
Phone: (910) 742-9243
Fax: (888) 746-1787

The provider's authorized official is Peggy Baddour .
The authorized official title is President/owner and has the following contact phone number (910) 777-9165.

The enumeration date for this NPI number is 2/15/2018 and was last updated on 3/25/2021.

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	Primary
1	103TC0700X	Psychologist	Clinical	No
2	1041C0700X	Social Worker	Clinical	No
3	207Q00000X	Family Medicine		No
4	2084P0800X	Psychiatry & Neurology	Psychiatry	No
5	363A00000X	Physician Assistant		No
6	363L00000X	Nurse Practitioner		No
7	208D00000X	General Practice		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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