Provider Demographics
NPI:1508057126
Name:INSIGHT FAMILY HEALTH CENTER, PLLC
Entity Type:Organization
Organization Name:INSIGHT FAMILY HEALTH CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TABETHA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:910-763-1960
Mailing Address - Street 1:3175 WRIGHTSVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-4184
Mailing Address - Country:US
Mailing Address - Phone:910-763-1960
Mailing Address - Fax:910-763-1961
Practice Address - Street 1:3175 WRIGHTSVILLE AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-4184
Practice Address - Country:US
Practice Address - Phone:910-763-1960
Practice Address - Fax:910-763-1961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC39512207Q00000X
NC200923363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCG26850Medicare UPIN