Provider Demographics
NPI:1669013553
Name:AT HOME MEDICAL CARE PLLC
Entity Type:Organization
Organization Name:AT HOME MEDICAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:LIZA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTON-VALDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, MSN, NP-C
Authorized Official - Phone:910-724-0182
Mailing Address - Street 1:10 LAKE HILLS RD
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-9639
Mailing Address - Country:US
Mailing Address - Phone:910-724-0182
Mailing Address - Fax:
Practice Address - Street 1:206 COMMERCE AVE
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-7059
Practice Address - Country:US
Practice Address - Phone:910-724-0182
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-02
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty