Healthcare Provider Details

I. General information

NPI: 1821923657
Provider Name (Legal Business Name): ELLIE MCINTOSH AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 MEADOWMONT VILLAGE CIR
CHAPEL HILL NC
27517-7506
US

IV. Provider business mailing address

600 W MAIN ST APT 506
DURHAM NC
27701-1793
US

V. Phone/Fax

Practice location:
  • Phone: 984-974-4479
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number30005192
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: