Healthcare Provider Details

I. General information

NPI: 1295224525
Provider Name (Legal Business Name): MATTHEW DANIEL HERRING FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2018
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 W BROAD ST
SAINT PAULS NC
28384-1533
US

IV. Provider business mailing address

217 W BROAD ST
SAINT PAULS NC
28384-1533
US

V. Phone/Fax

Practice location:
  • Phone: 910-241-3078
  • Fax:
Mailing address:
  • Phone: 910-241-3078
  • Fax: 910-241-3412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5010505
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5010505
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: