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Organization

FAYETTEVILLE ADVANCED PRACTITIONERS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAMIE ANN DICKERHOFF FNP-BC (NURSE PRACTITIONER, OWNER)
(910) 670-2047
Entity
Organization

Contact information

Practice address
2915 RAEFORD RD, FAYETTEVILLE, NC 28303-5508
(910) 670-2047
Mailing address
2915 RAEFORD RD, FAYETTEVILLE, NC 28303
(910) 670-2047

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
164680
NC
363LF0000X
Family Nurse Practitioner
Primary
148570
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1386970572
NPI
NC
01
245538461
NPI
NC
Enumeration date
03/06/2014
Last updated
03/26/2014
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