Healthcare Provider Details

I. General information

NPI: 1457285413
Provider Name (Legal Business Name): WHITLEY TYE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 NEWMAN RD
NEW BERN NC
28562-5253
US

IV. Provider business mailing address

203 TIMOTHY CT
NEW BERN NC
28562-9582
US

V. Phone/Fax

Practice location:
  • Phone: 252-635-6777
  • Fax: 252-634-3183
Mailing address:
  • Phone: 252-635-6777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5024665
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: