Individual
TATEISHA LYNELLE PAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
113 S PINE ST, WARSAW, NC 28398-1924
(910) 293-7246
Mailing address
113 S PINE ST, WARSAW, NC 28398-1924
(910) 293-7246
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-09435
NC
Other
Enumeration date
11/21/2019
Last updated
12/17/2019
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