Provider Demographics
NPI:1891916839
Name:MASSENGILL, ANNA BARBOUR (RNC, WHNP)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:BARBOUR
Last Name:MASSENGILL
Suffix:
Gender:F
Credentials:RNC, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1134 HAYES ROAD
Mailing Address - Street 2:
Mailing Address - City:FOUR OAKS
Mailing Address - State:NC
Mailing Address - Zip Code:27524
Mailing Address - Country:US
Mailing Address - Phone:919-894-5424
Mailing Address - Fax:
Practice Address - Street 1:45 SHOTWELL ROAD
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520
Practice Address - Country:US
Practice Address - Phone:919-550-5354
Practice Address - Fax:919-550-5766
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC800103363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health