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NPI Code Detail

MEDICARE: ANTHONY LAMONT HANSLEY

MEDICARE: ANTHONY LAMONT HANSLEY
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
11041C0700XClinical Social WorkerP013498NC

General Provider Information

NPI Number : 1326606385
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY LAMONT HANSLEY
Provider Business Mailing Address
First Line : 615 SHIPYARD BLVD
Second Line :
City : WILMINGTON
State : NC
Zip : 28412-6431
Country : US
Telephone Number : 910-790-0187
Fax Number : 910-790-0189
Provider Business Practice Location Address
First Line : 1806 S 15TH ST
Second Line :
City : WILMINGTON
State : NC
Zip : 28401-6479
Country : US
Telephone Number : 910-772-2515
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2019
Last Update Date : 06/04/2019

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Directions to “ ANTHONY LAMONT HANSLEY ” Practice Location

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