Fancy Gap Internal Medicine
Organization Active NPI Nurse Practitioner · Fancy Gap, VA
NPI 1043049828 · NPPES record last updated Jul 30, 2024
Key facts
- NPI
- 1043049828
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nurse Practitioner 363L00000X
- Legal business name
- FANCY GAP INTERNAL MEDICINE
- Practice address
- 1661 Turner Spur Rd
Fancy Gap, VA 24328-4365 - Phone
- (276) 728-0735
- Fax
- (866) 464-0644
- NPI assigned
- Jul 30, 2024
- Organization subpart
- No
Authorized official
- Name
- Mrs. Susan Tracy Roberts, NP-C
- Title
- Owner
- Phone
- (276) 728-0735
Practitioners 1
-
Susan Tracy Roberts, NP-C
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner |
363L00000X | Yes |
Addresses
Primary practice location
1661 Turner Spur Rd
Fancy Gap, VA 24328-4365
Mailing address
1661 Turner Spur Rd
Fancy Gap, VA 24328-4365
Phone (276) 728-0735
Other names
- Susan Tracy Roberts
Other providers in Fancy Gap, VA
- Stephanie Marie Davis
- Fancy Gap Internal Medicine
- H & S Enterprises, Inc.
- Susan Lee Jones
- Allison Mitchell
- Susan Tracy Roberts
All providers in Fancy Gap, VA · Nurse Practitioner in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.