Healthcare Provider Details

I. General information

NPI: 1740523737
Provider Name (Legal Business Name): BERNARD ENRIGHT NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2013
Last Update Date: 03/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 CAROLINA AVE
WASHINGTON NC
27889-3571
US

IV. Provider business mailing address

1201 CAROLINA AVE
WASHINGTON NC
27889-3571
US

V. Phone/Fax

Practice location:
  • Phone: 252-975-1111
  • Fax: 252-975-6696
Mailing address:
  • Phone: 252-975-1111
  • Fax: 252-975-6696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5005710
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: