| NPI | 1407025406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLYN C TEAGUE Nurse Practitioner 919-332-9547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health |
| 363LP2300X Nurse Practitioner Primary Care | |
| Enumeration Date | 2008-02-22 |
| Last Update Date | 2018-03-17 |