Provider Demographics
NPI:1184196214
Name:PEARCY, GINGER SWEENEY (LMBT)
Entity Type:Individual
Prefix:MS
First Name:GINGER
Middle Name:SWEENEY
Last Name:PEARCY
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2704 WOODMONT DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-2762
Mailing Address - Country:US
Mailing Address - Phone:310-892-2844
Mailing Address - Fax:
Practice Address - Street 1:6404 MCCRIMMON PARKWAY
Practice Address - Street 2:SUITE 230
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560
Practice Address - Country:US
Practice Address - Phone:310-892-2844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-31
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14567225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist