MEDICARE: MS. TANYA MARIE PAGETT RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC1500X	Community Health Registered Nurse	361589	NC

General Provider Information

NPI Number	:	1073472106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TANYA MARIE PAGETT RN

Provider Business Mailing Address
First Line	:	103 MARKET ST
Second Line	:
City	:	LOUISBURG
State	:	NC
Zip	:	27549-2523
Country	:	US
Telephone Number	:	919-443-4697
Fax Number	:

Provider Business Practice Location Address
First Line	:	103 MARKET ST
Second Line	:
City	:	LOUISBURG
State	:	NC
Zip	:	27549-2523
Country	:	US
Telephone Number	:	919-443-4697
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2026
Last Update Date	:	01/15/2026

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