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General NPI Number Information
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NPI Number | 1558759712
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Entity Type | Organization
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Legal Business Name | ACROSS THE LIFESPAN
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Dates
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Enumeration Date | 12/22/2014
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Last Update Date | 06/30/2022
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Provider Practice Location Address
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Address Line | 293 MAIN ST
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City | YANCEYVILLE
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State | NC
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Zip | 27379-8781
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Country | US
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Telephone | 336-504-6808
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3058
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City | ROXBORO
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State | NC
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Zip | 27573-3058
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Country | US
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Telephone | 336-504-6808
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TANILLYA WILKERSON PARTRIDGE
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Credential |
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Telephone | 336-694-1924
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5006150
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License Number State | NC
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