Healthcare Provider Details

I. General information

NPI: 1164489696
Provider Name (Legal Business Name): WOMEN'S HEALTH ALLIANCE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 06/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 NEW WAVERLY PL
CARY NC
27511-7412
US

IV. Provider business mailing address

550 NEW WAVERLY PL STE 200
CARY NC
27518-7412
US

V. Phone/Fax

Practice location:
  • Phone: 919-467-5941
  • Fax: 919-655-0532
Mailing address:
  • Phone: 919-467-0304
  • Fax: 919-655-0532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. JUDY H GARRETT
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 919-848-4080