Provider Demographics
NPI:1669111449
Name:THOMASSON, RACHEL LAIRD (FNP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:LAIRD
Last Name:THOMASSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 JANNIE LN
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:NC
Mailing Address - Zip Code:28327-7143
Mailing Address - Country:US
Mailing Address - Phone:910-354-8669
Mailing Address - Fax:
Practice Address - Street 1:3 REGIONAL CIR STE B
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-9845
Practice Address - Country:US
Practice Address - Phone:910-215-0111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-01
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5016259363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily