Healthcare Provider Details

I. General information

NPI: 1366369027
Provider Name (Legal Business Name): TESSA ANN HARTSELL FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1772 MAIN ST W
LOCUST NC
28097-9793
US

IV. Provider business mailing address

1772 MAIN ST W
LOCUST NC
28097-9793
US

V. Phone/Fax

Practice location:
  • Phone: 704-600-6113
  • Fax:
Mailing address:
  • Phone: 704-600-6113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number5024802
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: