Healthcare Provider Details

I. General information

NPI: 1205160025
Provider Name (Legal Business Name): SUSAN OXENDINE VALENTINE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2009
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 S LONG DR
ROCKINGHAM NC
28379-4835
US

IV. Provider business mailing address

155 MEMORIAL DR
PINEHURST NC
28374-8710
US

V. Phone/Fax

Practice location:
  • Phone: 910-417-3945
  • Fax:
Mailing address:
  • Phone: 910-715-1350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5019663
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: