Provider Demographics
NPI:1821539495
Name:SINGLETARY, TALISA CLARK (NP)
Entity Type:Individual
Prefix:MRS
First Name:TALISA
Middle Name:CLARK
Last Name:SINGLETARY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:TALISA
Other - Middle Name:SOMWANG
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1709 BERWICK DR STE B
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28352-5548
Mailing Address - Country:US
Mailing Address - Phone:910-276-2487
Mailing Address - Fax:910-276-2404
Practice Address - Street 1:1709 BERWICK DR STE B
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-5548
Practice Address - Country:US
Practice Address - Phone:910-276-2487
Practice Address - Fax:910-276-2404
Is Sole Proprietor?:No
Enumeration Date:2017-03-16
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5009380363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care