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Individual

BECKY T HERRMANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3505 CONVERSE DR STE 200, WILMINGTON, NC 28403-6132
(910) 392-5634
(910) 392-5654
Mailing address
3505 CONVERSE DR STE 200, WILMINGTON, NC 28403-6132
(910) 392-5634
(910) 392-5654

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10-02667
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1851480610
NC
Enumeration date
12/28/2010
Last updated
12/28/2010
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