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Organization
WAYNESBORO FAMILY CLINIC
Active
Organization
WAYNESBORO FAMILY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NITA VANNOSKE (CLINIC ADMINISTRATOR)
(919) 734-6676
Entity
Organization
Contact information
Practice address
1706 WAYNE MEMORIAL DR, GOLDSBORO, NC 27534-2240
(919) 734-6676
(919) 734-9050
Mailing address
1706 WAYNE MEMORIAL DR, GOLDSBORO, NC 27534-2240
(919) 734-6676
(919) 734-9050
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
291U00000X
Clinical Medical Laboratory
34D2077478
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3410001
—
NC
05
—
6005103
—
NC
05
—
8300477
—
NC
05
—
8300477B
—
NC
05
—
8300477G
—
NC
05
—
89015MK
—
NC
Enumeration date
07/11/2006
Last updated
08/31/2016
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