Provider Demographics
NPI:1750393336
Name:SANG, BARBARA LASSETER (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:LASSETER
Last Name:SANG
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MS
Other - First Name:BARBARA
Other - Middle Name:LASSETER
Other - Last Name:PERKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:2013 FERN DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5216
Mailing Address - Country:US
Mailing Address - Phone:252-328-6841
Mailing Address - Fax:252-328-0462
Practice Address - Street 1:1001 E 5TH ST
Practice Address - Street 2:MAILSTOP 408
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-2500
Practice Address - Country:US
Practice Address - Phone:252-328-6841
Practice Address - Fax:252-328-0462
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0050-01557363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCQ78931Medicare UPIN
NC2592846Medicare ID - Type UnspecifiedPROVIDER NUMBER