Healthcare Provider Details

I. General information

NPI: 1497687750
Provider Name (Legal Business Name): JUSTIN SCARBROUGH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 08/30/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1272 EAST ST
WAYNESVILLE NC
28786-3437
US

IV. Provider business mailing address

205 CALLIE RIVER CT
CLYDE NC
28721-0728
US

V. Phone/Fax

Practice location:
  • Phone: 828-456-3511
  • Fax: 828-456-3583
Mailing address:
  • Phone: 828-246-3112
  • Fax: 828-456-3583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5025309
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: