Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Fancy Gap Internal Medicine

Organization Nurse Practitioner · NPI 1043049828

Fancy Gap Internal Medicine is a Nurse Practitioner in Fancy Gap, Virginia. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

1661 Turner Spur Rd
Fancy Gap, VA 24328-4365
Phone: (276) 728-0735
Fax: (866) 464-0644
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X

Record details

NPI number1043049828
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Susan Roberts — Owner · (276) 728-0735
Other names Susan Tracy Roberts
NPI enumeratedJuly 30, 2024
Last updated in NPPESJuly 30, 2024
Certification dateJuly 30, 2024
Mailing address1661 Turner Spur Rd, Fancy Gap, VA 24328-4365