Taqiyyah Zafirah Betties, NP

Individual provider Active NPI Nurse Practitioner · Thomasville, NC

NPI 1669945937 · NPPES record last updated Oct 24, 2022

Key facts

NPI
1669945937
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
5011415 (NC)
Practice address
6329 Unity St Ste a
Thomasville, NC 27360-7186
Phone
(336) 793-2518
Fax
(336) 793-9589
NPI assigned
Jan 9, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
218310NCMDNurse Practitioner
5011415NCMDNurse Practitioner

Interoperability endpoints

  • Direct secure messaging: tcain144921@direct.novanthealth.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner
Group: 193400000X SINGLE SPECIALTY GROUP
363L00000X 218310 NC
Nurse Practitioner 363L00000X 5011415 NC Yes

Addresses

Primary practice location

6329 Unity St Ste a
Thomasville, NC 27360-7186

Mailing address

PO Box 604050
Charlotte, NC 28260-4050

Other practice location 1

4937 Old Country Club Rd
Winston Salem, NC 27104-5071
Phone (336) 718-4510

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address tcain144921@direct.novanthealth.org

Other providers in Thomasville, NC

All providers in Thomasville, NC · Nurse Practitioner in North Carolina

Sources for this page

Verify at the official NPI Registry.