Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 5013428 | NC |
NPI | 1467066118 |
---|---|
Provider Name | Mrs. Tabitha Silvers Fox |
First Address | Burnsville, NC 28714-9004 |
Second Address | Burnsville, NC 28714-9004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2020 |
Last Update Date | 01/09/2020 |