Healthcare Provider Details

I. General information

NPI: 1861464083
Provider Name (Legal Business Name): TANIA OBREMSKI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 03/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2577 W 5TH ST
GREENVILLE NC
27834-7813
US

IV. Provider business mailing address

2577 W. 5TH ST. WALTER B. JONES ALCOHOL AND DRUG ABUSE TREATMENT CENTER
GREENVILLE NC
27834
US

V. Phone/Fax

Practice location:
  • Phone: 252-830-3426
  • Fax: 252-830-8585
Mailing address:
  • Phone: 252-830-3426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number09-00117
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number09-00117
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: