Healthcare Provider Details

I. General information

NPI: 1447791629
Provider Name (Legal Business Name): ANN ELIZABETH SYMONDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2017
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 SAGE RD
CHAPEL HILL NC
27514-6510
US

IV. Provider business mailing address

201 SAGE RD
CHAPEL HILL NC
27514-6510
US

V. Phone/Fax

Practice location:
  • Phone: 802-522-6077
  • Fax:
Mailing address:
  • Phone: 919-385-2030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2020-02489
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: