Individual
MRS. CARLY ANN PORTINCASA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
120 QUAIL RUN, PINEHURST, NC 28374-9096
(727) 743-8873
Mailing address
120 QUAIL RUN, PINEHURST, NC 28374-9096
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
366682
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2025097591
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5023932
NC
Other
Enumeration date
09/24/2025
Last updated
05/04/2026
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