Provider Information for 1669914735
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VANESSA UPSHIRE-TRIBBLE
Sex: Female
NPI: 1669914735
Last Updated: 2022-02-17
Certification Date: 2022-02-17
Certification Date: 2022-02-17
Details
| Name | Value | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1669914735 | ||||||||||||||||
| Enumeration Date | 2016-11-07 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 2732 ANN ELIZABETH DR BURLINGTON, NC 27215-5111 United States Phone: 336-229-5905 | Fax:336-229-5906 | ||||||||||||||||
| Primary Practice Address | 2732 ANN ELIZABETH DR BURLINGTON, NC 27215-5111 United States Phone: 336-229-5905 | Fax:336-229-5906 | ||||||||||||||||
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