SNEADS FERRY PEDIATRICS PC NPI 1871855379

NPI Information

NPI: 1871855379
Provider Name: SNEADS FERRY PEDIATRICS PC
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Organization

Specialization: Pediatrics

CLIA Number: 34D2046753

Address:
108 LAKESIDE DR
SNEADS FERRY, NC
ZIP 28460
Phone: (910) 327-5437
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SNEADS FERRY PEDIATRICS PC is a pediatrics nurse practitioner in Sneads Ferry, NC. SNEADS FERRY PEDIATRICS PC NPI is 1871855379. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

108 LAKESIDE DR
SNEADS FERRY, NC
ZIP 28460-415
Phone: (910) 327-5437
Fax: (877) 505-8468

The provider's authorized official is Jack Wilcox .
The authorized official title is Ceo and has the following contact phone number (910) 327-5437.

The CLIA number assigned to this NPI record is 34D2046753 - other practitioner with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/11/2012 and was last updated on 6/11/2012.

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	363LP0200X	Nurse Practitioner	Pediatrics	20000007	NORTH CAROLINA	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: 11/14/2023

NPI Synchronization or Removal

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