Healthcare Provider Details

I. General information

NPI: 1740125632
Provider Name (Legal Business Name): NEW JOURNEY FAMILY PRACTICE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 S MAIN ST STE A
RED SPRINGS NC
28377-1621
US

IV. Provider business mailing address

229 S MAIN ST STE A
RED SPRINGS NC
28377-1621
US

V. Phone/Fax

Practice location:
  • Phone: 910-674-8887
  • Fax:
Mailing address:
  • Phone: 910-674-8887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LARISSA DEESE
Title or Position: OWNER
Credential: NP
Phone: 910-674-8887