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General NPI Number Information
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NPI Number | 1790336964
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Entity Type | Individual
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Provider Name | MANDY LYNN TUTTLE MSN, APRN, NP-C
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Gender | Female
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Dates
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Enumeration Date | 09/27/2019
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 3694 MOIR FARM RD
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City | SANDY RIDGE
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State | NC
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Zip | 27046-7500
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Country | US
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Telephone | 743-444-9848
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Fax | 336-866-3346
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Provider Business Mailing Address
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Address Line | 3694 MOIR FARM RD
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City | SANDY RIDGE
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State | NC
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Zip | 27046-7500
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Country | US
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Telephone | 743-444-9848
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Fax | 336-866-3346
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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 | F06192515
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5012351
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License Number State | NC
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