Individual
ANNIE PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
130 PINE STATE ST STE C, LILLINGTON, NC 27546-9414
(910) 474-0050
Mailing address
130 PINE STATE ST STE C, LILLINGTON, NC 27546-9414
(910) 474-0050
(863) 228-8484
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5021862
NC
Other
Enumeration date
03/24/2025
Last updated
07/18/2025
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