MS. NICOLE MARIE ETEO (NPI# 1265801815) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265801815 |
| Entity Type | Individual |
| Full Name | MS. NICOLE MARIE ETEO |
| Credential | CPNP |
| Practice Address |
195 W Illinois Ave Southern Pines NC 28387-5808 |
| Mailing Address |
195 W Illinois Ave Attn: Rosa Galvez Southern Pines NC 28387-5808 |
| Practice Telephone | 9106922444 |
| Mailing Telephone | 9106922444 |
| Enumeration Date | 2015-09-24 |
| Last Update Date | 2020-05-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
5008014 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
195 W ILLINOIS AVE |
| City | SOUTHERN PINES |
| State | NC |
| Zip Code | 28387-5808 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114998150 | Sandhills Pediatrics | Psychiatry & Neurology | 195 W Illinois Ave, Southern Pines, NC 28387-5808 | 2006-01-28 |
| 1497211023 | Melissa Pierce | Counselor | 195 W Illinois Ave, Southern Pines, NC 28387-5808 | 2019-02-19 |
| 1861987117 | Hattie Mccall | Physician Assistant | 195 W Illinois Ave, Southern Pines, NC 28387-5808 | 2018-06-28 |
| 1316440746 | Catherine Tucker | Counselor | 195 W Illinois Ave, Southern Pines, NC 28387-5808 | 2018-03-12 |
| 1063937688 | Lauren Dembnicki Massey | Nurse Practitioner | 195 W Illinois Ave, Southern Pines, NC 28387-5808 | 2017-08-04 |
| 1073907994 | Laura Caroline Colas | Counselor | 195 W Illinois Ave, Southern Pines, NC 28387-5808 | 2015-03-28 |
| 1275948655 | Sarah Elizabeth Carr | Pediatrics | 195 W Illinois Ave, Southern Pines, NC 28387-5808 | 2014-06-24 |
| 1316363252 | Gwendolyn Denise Garcia | Nurse Practitioner | 195 W Illinois Ave, Southern Pines, NC 28387-5808 | 2014-03-17 |
| 1437571312 | Matthew Brian Thompson | Nurse Practitioner | 195 W Illinois Ave, Southern Pines, NC 28387-5808 | 2014-01-13 |
| 1275872236 | Elizabeth Mcneill Hodgin | Nurse Practitioner | 195 W Illinois Ave, Southern Pines, NC 28387-5808 | 2013-02-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861972028 | Wright and Associates X Dds Pa | Dentist | 10677 Nc Hwy 15-501, Southern Pines, NC 28387 | 2018-08-17 |
| 1821507294 | Brooke Ashley Thomas | Physical Therapist | 275 Pinehurst Ave Suite B, Southern Pines, NC 28387 | 2017-09-28 |
| 1497208987 | Laura Permelia Jackson | Specialist/Technologist | 3300 Airport Road, Southern Pines, NC 28387 | 2016-08-01 |
| 1164860417 | Monarch | Community/Behavioral Health | 1662 Richards St, Southern Pines, NC 28387 | 2013-06-10 |
| 1619313202 | Nicole Jacobs | Psychiatry & Neurology | 195 West Illinois Avenue, Attn: April Smith, Southern Pines, NC 28387 | 2013-05-22 |
| 1932458395 | Heather N Dunning | Social Worker | 230 Murray Hill Rd, Southern Pines, NC 28387 | 2012-08-31 |
| 1487948451 | Hugh Perry Gayman Jr. | Physical Therapist | 103 Gossman Dr, Southern Pines, NC 28387 | 2011-06-07 |
| 1083919245 | John Adam Petty | Chiropractor | 1295 Old Us 1, Suite F, Southern Pines, NC 28387 | 2011-01-20 |
| 1962704775 | Specialty Pharmacy-southern Pines LLC | Pharmacy | 735 S. Bennett St., Southern Pines, NC 28387 | 2010-11-30 |
| 1922317080 | At Home Senior Services, Inc. | Home Health | 340 Commerce Avenue, Suite 14-a Yadkin Plaza, Southern Pines, NC 28387 | 2010-10-06 |
| Find all providers in zip 28387 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952933970 | Kameron Ansley Sperduto | Nurse Practitioner | 195 West Illinois Avenue, Attn: Melanie Godfrey, Southern Pines, NC 28387 | 2020-02-07 |
| 1316363252 | Gwendolyn Denise Garcia | Nurse Practitioner | 195 W Illinois Ave, Southern Pines, NC 28387-5808 | 2014-03-17 |
| 1093157224 | Erica Biles Vincent | Nurse Practitioner | 135 Turner St, Southern Pines, NC 28387-7054 | 2013-07-30 |
| 1275872236 | Elizabeth Mcneill Hodgin | Nurse Practitioner | 195 W Illinois Ave, Southern Pines, NC 28387-5808 | 2013-02-11 |
| 1720226236 | Premier Pediatrics, Pa | Nurse Practitioner | 135 Turner St, Southern Pines, NC 28387-7054 | 2009-01-22 |
| 1770558868 | Amy S. Ivey | Nurse Practitioner | 195 W Illinois Ave, Southern Pines, NC 28387-5808 | 2006-02-22 |
| 1972578433 | Melissa Andrews | Nurse Practitioner | 195 W Illinois Ave, Southern Pines, NC 28387-5808 | 2006-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811594732 | Megan Hoekstra | Nurse Practitioner | 8358 Six Forks Rd Ste 204, Raleigh, NC 27615-5093 | 2020-10-04 |
| 1639713118 | Holly Hattler Barber | Nurse Practitioner | Unc Dept of Pediatrics 030 Macnider Hall Cb 7231, Chapel Hill, NC 27599-0001 | 2019-10-29 |
| 1437709565 | Molly Benson Miller | Nurse Practitioner | 101 Manning Dr Cb 7236, Chapel Hill, NC 27599-7236 | 2019-09-20 |
| 1407406267 | Michelle Ferricher | Nurse Practitioner | Naval Medical Center Pediatric Clinic, Nh-200 Recovery Way, Camp Lejeune, NC 28547 | 2019-09-13 |
| 1548814072 | Ashley Goodwin Friddle | Nurse Practitioner | 802 Green Valley Rd Ste 210, Greensboro, NC 27408-7099 | 2019-08-01 |
| 1740743129 | Jennifer W Farrow | Nurse Practitioner | 940 Se Cary Pkwy Ste 200, Cary, NC 27518-7417 | 2019-04-11 |
| 1538641147 | Taylor Rippy | Nurse Practitioner | 2304 Delaney Ave, Wilmington, NC 28403-6013 | 2018-08-30 |
| 1427544931 | Sheila L Mason | Nurse Practitioner | Wfbmc 1 Medical Center Blvd, Winston Salem, NC 27157-0001 | 2018-07-09 |
| 1770099319 | Jillian Hernandez Sprague | Nurse Practitioner | 101 E Matthews St Ste 800, Matthews, NC 28105-5374 | 2017-12-19 |
| 1427587625 | Amanda Register | Nurse Practitioner | 110 E Park Dr, Beulaville, NC 28518-6916 | 2017-06-09 |
| Find all providers with the same taxonomy | ||||
| City | SOUTHERN PINES |
| Zip Code | 28387 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.