Provider Demographics
NPI:1376190751
Name:SEMBLY, TAYESHAWN LARRAINE (DNP, APRN, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:TAYESHAWN
Middle Name:LARRAINE
Last Name:SEMBLY
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:467 BROWNSTONE DR
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-8673
Mailing Address - Country:US
Mailing Address - Phone:910-853-1741
Mailing Address - Fax:
Practice Address - Street 1:55 CENTENNIAL PKWY
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:NC
Practice Address - Zip Code:28326-4013
Practice Address - Country:US
Practice Address - Phone:910-908-7316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-21
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCSEMB-7IJN8Q363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily