1750393336 NPI number — MRS. BARBARA LASSETER SANG FNP-BC

Table of content: MRS. BARBARA LASSETER SANG FNP-BC (NPI 1750393336)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750393336 NPI number — MRS. BARBARA LASSETER SANG FNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SANG
Provider First Name:
BARBARA
Provider Middle Name:
LASSETER
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PERKINS
Provider Other First Name:
BARBARA
Provider Other Middle Name:
LASSETER
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
FNP-BC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1750393336
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/21/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2013 FERN DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27858-5216
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
252-328-6841
Provider Business Mailing Address Fax Number:
252-328-0462

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1001 E 5TH ST
Provider Second Line Business Practice Location Address:
MAILSTOP 408
Provider Business Practice Location Address City Name:
GREENVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27858-2500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-328-6841
Provider Business Practice Location Address Fax Number:
252-328-0462
Provider Enumeration Date:
08/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  0050-01557 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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