| NPI | 1487612628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA J TETREAULT President 919-938-3749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 147337) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2024-09-23 |