=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750027769
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANJANETTE BARRICK-PHILLIPS PA-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/11/2022
-----------------------------------------------------
Last Update Date | 08/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4204 MURDOCKSVILLE RD
-----------------------------------------------------
City | WEST END
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27376-8871
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-860-0728
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 875 BARBER RD
-----------------------------------------------------
City | SOUTHERN PINES
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28387-6623
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | 0010-13582
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------