Healthcare Provider Details

I. General information

NPI: 1467000950
Provider Name (Legal Business Name): ALBERT BART-PLANGE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2019
Last Update Date: 06/21/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

673 CARDINAL DR
HENDERSON NC
27536-5105
US

IV. Provider business mailing address

1776 HERITAGE CENTER DR STE 204
WAKE FOREST NC
27587-3977
US

V. Phone/Fax

Practice location:
  • Phone: 252-654-6406
  • Fax:
Mailing address:
  • Phone: 919-263-0582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3013567
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: