Organization
COASTAL HEADACHE CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRA KAMP FNP (PRESIDENT)
(614) 571-4245
Entity
Organization
Contact information
Practice address
1715 COUNTRY CLUB RD STE B, JACKSONVILLE, NC 28546-6042
(910) 238-2050
Mailing address
1715 COUNTRY CLUB RD STE B, JACKSONVILLE, NC 28546-6042
(910) 238-2050
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
03/03/2022
Last updated
09/17/2022
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