Healthcare Provider Details

I. General information

NPI: 1831984525
Provider Name (Legal Business Name): TORI ASHLEE THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2025
Last Update Date: 04/12/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4111 WENDELL BLVD
WENDELL NC
27591-6831
US

IV. Provider business mailing address

9726 CHAPMAN RD
BAILEY NC
27807-7600
US

V. Phone/Fax

Practice location:
  • Phone: 919-365-8484
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5021985
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: