Healthcare Provider Details

I. General information

NPI: 1538430855
Provider Name (Legal Business Name): NANCY C. PARTIN SPEECH-LANGUAGE PATH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2012
Last Update Date: 01/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1214 PARKWAY DR
GOLDSBORO NC
27534-3448
US

IV. Provider business mailing address

PO BOX 10723
GOLDSBORO NC
27532-0723
US

V. Phone/Fax

Practice location:
  • Phone: 919-739-0047
  • Fax: 919-739-9041
Mailing address:
  • Phone: 919-739-0047
  • Fax: 919-739-9041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number170
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: