Healthcare Provider Details

I. General information

NPI: 1861300378
Provider Name (Legal Business Name): COURTNEY THIGPEN EISERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

5 FIRST VILLAGE DR
PINEHURST NC
28374-9495
US

IV. Provider business mailing address

5 FIRST VILLAGE DR
PINEHURST NC
28374-9495
US

V. Phone/Fax

Practice location:
  • Phone: 910-295-6831
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5025310
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: