Provider Demographics
NPI:1972758480
Name:PEARSON, WILLIAM ELLIOTTE II (ANP-BC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ELLIOTTE
Last Name:PEARSON
Suffix:II
Gender:M
Credentials:ANP-BC
Other - Prefix:
Other - First Name:ELLIOTTE
Other - Middle Name:
Other - Last Name:PEARSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ANP-BC
Mailing Address - Street 1:2930 LITTLE GEM CIR
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-7872
Mailing Address - Country:US
Mailing Address - Phone:252-917-0308
Mailing Address - Fax:
Practice Address - Street 1:102 PARKWOOD DR
Practice Address - Street 2:
Practice Address - City:SNOW HILL
Practice Address - State:NC
Practice Address - Zip Code:28580-1336
Practice Address - Country:US
Practice Address - Phone:252-747-5510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-25
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC152143363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner