Provider Demographics
NPI:1821635830
Name:FOSNIGHT CENTER FOR SEXUAL HEALTH, PLLC
Entity Type:Organization
Organization Name:FOSNIGHT CENTER FOR SEXUAL HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEECE
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:828-384-0494
Mailing Address - Street 1:250 HAWTHORNE DR
Mailing Address - Street 2:
Mailing Address - City:BREVARD
Mailing Address - State:NC
Mailing Address - Zip Code:28712-3492
Mailing Address - Country:US
Mailing Address - Phone:828-384-0494
Mailing Address - Fax:
Practice Address - Street 1:6 YORKSHIRE ST STE D
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2768
Practice Address - Country:US
Practice Address - Phone:828-384-0494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-09
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty