Healthcare Provider Details

I. General information

NPI: 1396668877
Provider Name (Legal Business Name): JOANNE EHRET
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 WILLIAMSBURG PKWY # A
JACKSONVILLE NC
28546-6856
US

IV. Provider business mailing address

255 WILLIAMSBURG PKWY # A
JACKSONVILLE NC
28546-6856
US

V. Phone/Fax

Practice location:
  • Phone: 866-416-1238
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5025102
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: