MEDICARE: MRS. NANCY ANN HAPP OT R/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0200X	Pediatric Occupational Therapist	3566	NC
2	225X00000X	Occupational Therapist	3566	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	130RW	OTHER	NC	BC

General Provider Information

NPI Number	:	1083675375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NANCY ANN HAPP OT R/L

Provider Business Mailing Address
First Line	:	PO BOX 12192
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28561-2192
Country	:	US
Telephone Number	:	252-672-8676
Fax Number	:	252-672-8677

Provider Business Practice Location Address
First Line	:	2805B TRENT RD
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-2029
Country	:	US
Telephone Number	:	252-672-8676
Fax Number	:	252-672-8677

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	09/19/2024

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