Healthcare Provider Details

I. General information

NPI: 1518434950
Provider Name (Legal Business Name): CHERYL PAIGE PATEL RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2018
Last Update Date: 10/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2128 HIGH HOUSE RD
CARY NC
27519-8443
US

IV. Provider business mailing address

2128 HIGH HOUSE RD
CARY NC
27519-8443
US

V. Phone/Fax

Practice location:
  • Phone: 919-336-5245
  • Fax: 919-336-5246
Mailing address:
  • Phone: 919-336-5245
  • Fax: 919-336-5246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number233771
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code163WN0003X
TaxonomyLow-Risk Neonatal Registered Nurse
License Number233771
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code163WN1003X
TaxonomyNutrition Support Registered Nurse
License Number233771
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number233771
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number233771
License Number StateNC
# 6
Primary TaxonomyN
Taxonomy Code163WP1700X
TaxonomyPerinatal Registered Nurse
License Number233771
License Number StateNC
# 7
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number233771
License Number StateNC
# 8
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number233771
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: