Teddie Wayne Gore FNP

NPI 1255566154 - Nurse Practitioner - 363LF0000X

NPI Details
NPI 1255566154
Gender Male
Enumeration Date 05/20/2009
Last Updated 05/20/2009
Entity Type Individual
Active Over 7 years ago
Practice Location
2100 STANTONSBURG ROAD
ECHI AT PCMH
GREENVILLE NC, 27835, US
Phone (252) 847-2181
Fax (252) 847-2213
Business Location
PO BOX 8423
GREENVILLE NC, 27835-8423, US
Phone (252) 847-2181
Fax (252) 847-2213
Toxanomy
Taxonomy Code 363LF0000X
License State North Carolina
License Number 5004377
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According to our database, Mr. Teddie Wayne Gore FNP NPI is 1255566154, taxonomy code is 363LF0000X and license number is 5004377, license state is located at North Carolina. Teddie Wayne Gore FNP physically located at 2100 Stantonsburg Road, Greenville NC, 27835. NPI Number Teddie Wayne Gore FNP has the Individual type.

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1255566154 NPI number is provided on an as is basis without warranty of any kind. 1255566154 is maintained by the National Plan & Provider Enumeration System. The contents of Teddie Wayne Gore FNP are for informational purposes only.