=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952881567
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALISIA ANN ENRIQUEZ NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/14/2018
-----------------------------------------------------
Last Update Date | 12/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2817 ROCK MERRITT AVE STOP A
-----------------------------------------------------
City | FAYETTEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28310
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-908-4673
-----------------------------------------------------
Fax | 910-908-2240
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2817 ROCK MERRITT AVE STOP A
-----------------------------------------------------
City | FORT BRAGG
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28310-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-908-4673
-----------------------------------------------------
Fax | 908-425-9120
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 5010818
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------