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Organization

ACROSS THE LIFESPAN

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TANILLYA WILKERSON PARTRIDGE (PRESIDENT)
(336) 694-1924
Entity
Organization

Contact information

Practice address
293 MAIN ST, YANCEYVILLE, NC 27379-8781
(336) 504-6808
Mailing address
PO BOX 3058, ROXBORO, NC 27573-3058
(336) 504-6808

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
363LF0000X
Family Nurse Practitioner
Primary
5006150
NC

Other

Enumeration date
12/22/2014
Last updated
06/30/2022
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