Provider Demographics
NPI:1275050718
Name:HADLEY, TEGAN MARIE (APN, FNP-C)
Entity Type:Individual
Prefix:
First Name:TEGAN
Middle Name:MARIE
Last Name:HADLEY
Suffix:
Gender:F
Credentials:APN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7307
Mailing Address - Country:US
Mailing Address - Phone:910-617-6705
Mailing Address - Fax:
Practice Address - Street 1:206 N DYSON ST
Practice Address - Street 2:
Practice Address - City:HOLLY RIDGE
Practice Address - State:NC
Practice Address - Zip Code:28445-8502
Practice Address - Country:US
Practice Address - Phone:910-989-4888
Practice Address - Fax:910-329-1582
Is Sole Proprietor?:No
Enumeration Date:2017-08-25
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5011229363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner