Healthcare Provider Details

I. General information

NPI: 1114191863
Provider Name (Legal Business Name): BARBARA GRACE TRUMBLE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2008
Last Update Date: 04/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 E MILLS ST
COLUMBUS NC
28722-0018
US

IV. Provider business mailing address

45 E MILLS ST
COLUMBUS NC
28722-0018
US

V. Phone/Fax

Practice location:
  • Phone: 828-894-8213
  • Fax: 828-894-5775
Mailing address:
  • Phone: 828-894-8213
  • Fax: 828-894-5775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number069679
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: