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NPI 1497931141

NPI 1497931141 : KATHLEEN VASSAUR NP-C : FAYETTEVILLE, NC

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General NPI Number Information
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    NPI Number           |    1497931141
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    Entity Type          |    Individual 
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    Provider Name        |    KATHLEEN VASSAUR NP-C
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/11/2008
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    Last Update Date     |    07/07/2025
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Provider Practice Location Address
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    Address Line         |    1638 OWEN DR 
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    City                 |    FAYETTEVILLE
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    State                |    NC
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    Zip                  |    28304-3424
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    Country              |    US
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    Telephone            |    910-615-5680
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    Fax                  |    910-615-5080
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Provider Business Mailing Address
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    Address Line         |    PO BOX 40908 
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    City                 |    FAYETTEVILLE
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    State                |    NC
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    Zip                  |    28309-0908
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    Country              |    US
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    Telephone            |    910-615-6949
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    Fax                  |    910-615-9761
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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       |    5003882
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    License Number State |    NC
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