Healthcare Provider Details

I. General information

NPI: 1457897282
Provider Name (Legal Business Name): ANNE MARIE GROWNEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNE MARIE WEINHOLD PA

II. Dates (important events)

Enumeration Date: 01/18/2017
Last Update Date: 10/01/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1072 NC-210 STE A
SNEADS FERRY NC
28460
US

IV. Provider business mailing address

1072 NC-210 STE A
SNEADS FERRY NC
28460
US

V. Phone/Fax

Practice location:
  • Phone: 910-685-7307
  • Fax: 888-964-2415
Mailing address:
  • Phone: 910-685-7307
  • Fax: 888-964-2415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110005610
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: