Healthcare Provider Details

I. General information

NPI: 1326599523
Provider Name (Legal Business Name): LAURIE ANN NILSEN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2016
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6330 QUADRANGLE DR
CHAPEL HILL NC
27517-8279
US

IV. Provider business mailing address

111 HERITAGE LN
HENRICO NC
27842-9267
US

V. Phone/Fax

Practice location:
  • Phone: 919-932-5700
  • Fax:
Mailing address:
  • Phone: 919-932-5700
  • Fax: 919-933-8661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP016666
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number5011134
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberSP016666
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5011134
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: