Provider Demographics
NPI:1265548671
Name:PAGE, CONSTANCE DALE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:CONSTANCE
Middle Name:DALE
Last Name:PAGE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 JACKSON TRAIL
Mailing Address - Street 2:
Mailing Address - City:DUNN
Mailing Address - State:NC
Mailing Address - Zip Code:28334
Mailing Address - Country:US
Mailing Address - Phone:910-892-4329
Mailing Address - Fax:
Practice Address - Street 1:700 TILGHMAN DR
Practice Address - Street 2:SUITE720
Practice Address - City:DUNN
Practice Address - State:NC
Practice Address - Zip Code:28334-0007
Practice Address - Country:US
Practice Address - Phone:910-892-4941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2025-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC001000372363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical