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General NPI Number Information
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NPI Number | 1144212754
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Entity Type | Individual
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Provider Name | LISA YANCEY COLTRANE MSN, RNCS, FNP
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Gender | Female
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Dates
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Enumeration Date | 08/19/2005
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Last Update Date | 06/16/2021
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Provider Practice Location Address
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Address Line | 1473 NC HWY 42-43 W
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City | PINETOPS
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State | NC
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Zip | 27864-7188
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Country | US
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Telephone | 252-827-5231
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Fax | 252-827-5775
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Provider Business Mailing Address
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Address Line | 900 TRADE ST
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City | TARBORO
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State | NC
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Zip | 27886-3855
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Country | US
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Telephone | 252-823-0718
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 200906
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License Number State | NC
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