Healthcare Provider Details

I. General information

NPI: 1619379708
Provider Name (Legal Business Name): KATHLEEN MARIE SAAS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2014
Last Update Date: 04/09/2020
Certification Date: 04/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 ASHVILLE AVE STE 310
CARY NC
27518-8682
US

IV. Provider business mailing address

9160 FORUM CORPORATE PKWY STE 350
FORT MYERS FL
33905-7808
US

V. Phone/Fax

Practice location:
  • Phone: 919-233-8585
  • Fax:
Mailing address:
  • Phone: 239-785-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5007125
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: