Healthcare Provider Details

I. General information

NPI: 1679484257
Provider Name (Legal Business Name): TERRA ANDERSON FLETCHER AG-ACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

628 E 12TH ST
WASHINGTON NC
27889-3409
US

IV. Provider business mailing address

2309 BRADDY RD
WASHINGTON NC
27889-3269
US

V. Phone/Fax

Practice location:
  • Phone: 252-974-9361
  • Fax:
Mailing address:
  • Phone: 252-975-4110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number5025413
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: