Healthcare Provider Details

I. General information

NPI: 1881672772
Provider Name (Legal Business Name): JAMES C NOURSE PH.D., L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 12/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 MEDICAL PARK DR
BREVARD NC
28712-3035
US

IV. Provider business mailing address

89 MEDICAL PARK DR
BREVARD NC
28712-3035
US

V. Phone/Fax

Practice location:
  • Phone: 828-698-8036
  • Fax: 828-696-8304
Mailing address:
  • Phone: 828-698-8036
  • Fax: 828-696-8304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2173
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number332
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: