Provider Demographics
NPI:1457246845
Name:PRIME HEALTHCARE
Entity type:Organization
Organization Name:PRIME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:FETZER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:919-381-1773
Mailing Address - Street 1:2571 HAWKINS AVE
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-9236
Mailing Address - Country:US
Mailing Address - Phone:919-381-1773
Mailing Address - Fax:919-335-9538
Practice Address - Street 1:2571 HAWKINS AVE
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-9236
Practice Address - Country:US
Practice Address - Phone:919-381-1773
Practice Address - Fax:919-335-9538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care