MEDICARE: AUDREY MRAD RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	264544	NC

General Provider Information

NPI Number	:	1861356123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUDREY MRAD RN

Provider Business Mailing Address
First Line	:	1010 STARLIGHT DR
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27707-2134
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 MANNING DR
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27514-4220
Country	:	US
Telephone Number	:	984-215-3078
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/11/2025

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