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NPI Code Detail

MEDICARE: MS. SONDRA SUE TANNEHILL P.A.

MEDICARE:  MS. SONDRA SUE TANNEHILL  P.A.
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
1363A00000XPhysician Assistant00010-00774NC

General Provider Information

NPI Number : 1639214158
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SONDRA SUE TANNEHILL P.A.
Provider Business Mailing Address
First Line : 2930 VILLAGE DR
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-3815
Country : US
Telephone Number : 910-323-9010
Fax Number : 910-323-9568
Provider Business Practice Location Address
First Line : 150 ROBESON ST
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28301-5570
Country : US
Telephone Number : 910-615-1000
Fax Number : 910-615-1020
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2007
Last Update Date : 09/04/2025

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Directions to “ MS. SONDRA SUE TANNEHILL P.A.” Practice Location

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