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General NPI Number Information
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NPI Number | 1285597740
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Entity Type | Individual
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Provider Name | OCTAVIA NICOLE THIGPEN
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Gender | Female
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 107 RALEIGH ROAD PKWY W
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City | WILSON
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State | NC
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Zip | 27893-2948
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Country | US
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Telephone | 919-283-6113
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Fax | 252-265-3845
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Provider Business Mailing Address
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Address Line | 1108 GREENBRIAR RD NW
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City | WILSON
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State | NC
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Zip | 27896-2147
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Country | US
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Telephone | 919-283-6113
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Fax | 252-265-3845
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State | NC
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