Provider Demographics
NPI:1205171642
Name:JOHN, TESS SEBASTIAN (FNP)
Entity type:Individual
Prefix:MRS
First Name:TESS
Middle Name:SEBASTIAN
Last Name:JOHN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
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Mailing Address - Street 1:350 PINE STATE ST
Mailing Address - Street 2:
Mailing Address - City:LILLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27546-9428
Mailing Address - Country:US
Mailing Address - Phone:910-893-9700
Mailing Address - Fax:910-893-9747
Practice Address - Street 1:2301 ERWIN RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4699
Practice Address - Country:US
Practice Address - Phone:919-997-4672
Practice Address - Fax:919-997-4674
Is Sole Proprietor?:No
Enumeration Date:2012-12-11
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC142414363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily