Organization
COASTAL SOUTHEASTERN FAMILY PRACTICE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATARA S CHAVIS FNP (PRESIDENT)
(910) 521-0099
Entity
Organization
Contact information
Practice address
205 W 3RD ST, PEMBROKE, NC 28372-8768
(910) 521-0099
(910) 521-0088
Mailing address
205 W 3RD ST, PEMBROKE, NC 28372-8768
(910) 521-0099
(910) 521-0088
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5005148
NC
Other
Enumeration date
05/11/2011
Last updated
03/07/2017
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