Healthcare Provider Details

I. General information

NPI: 1508784695
Provider Name (Legal Business Name): OUTER BANKS ACUPUNCTURE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

111 E BALTIC ST
NAGS HEAD NC
27959-0108
US

IV. Provider business mailing address

101 W AIRSTRIP RD # 253
KILL DEVIL HILLS NC
27948-8314
US

V. Phone/Fax

Practice location:
  • Phone: 252-216-1117
  • Fax:
Mailing address:
  • Phone: 252-216-1117
  • Fax: 717-613-7815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: TRACEY E HANSEL
Title or Position: OWNER
Credential: MD
Phone: 252-216-1117