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

Annie Phan

Individual provider Nurse Practitioner · NPI 1003617184

Annie Phan is a Nurse Practitioner in Lillington, North Carolina. Qualified in 2024, 2 years ago. Practices as a sole proprietor. Licensed in North Carolina.

Years since qualifying
2
Licensed in
NC
In the registry since
2025

Practice location Address checks out

130 Pine State St Ste C
Lillington, NC 27546-9414
Phone: (910) 474-0050
Show map & directions

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

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 5021862 (NC)

Record details

NPI number1003617184
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 24, 2025
Last updated in NPPESJuly 18, 2025
Certification dateJuly 18, 2025
Mailing address130 Pine State St Ste C, Lillington, NC 27546-9414

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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