Provider Demographics
NPI:1982112066
Name:BOLLIN, TASHA WESTBROOK (RN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:TASHA
Middle Name:WESTBROOK
Last Name:BOLLIN
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Gender:
Credentials:RN, FNP-C
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Other - First Name:
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Mailing Address - Street 1:3484 US HIGHWAY 13 S
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-1025
Mailing Address - Country:US
Mailing Address - Phone:919-689-2222
Mailing Address - Fax:919-689-2241
Practice Address - Street 1:3484 US HIGHWAY 13 S
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-1025
Practice Address - Country:US
Practice Address - Phone:919-689-2222
Practice Address - Fax:919-689-2241
Is Sole Proprietor?:No
Enumeration Date:2018-01-11
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5010172363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5010172OtherNURSE PRACTITIONER LICENSE NUMBER