Healthcare Provider Details

I. General information

NPI: 1750929360
Provider Name (Legal Business Name): MRS. FRANCESCA ESDAILE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2019
Last Update Date: 04/17/2024
Certification Date: 04/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501A BRAGG BLVD
FAYETTEVILLE NC
28303-4141
US

IV. Provider business mailing address

2501 BRAGG BLVD STE A
FAYETTEVILLE NC
28303-4141
US

V. Phone/Fax

Practice location:
  • Phone: 929-301-6265
  • Fax:
Mailing address:
  • Phone: 929-301-6265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number338409
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN113040
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number303227
License Number StateAZ
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5019358
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number783199
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: