Healthcare Provider Details

I. General information

NPI: 1053221796
Provider Name (Legal Business Name): ALICE MARIE RUNYON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALICE MARIE CASTANG

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6330 QUADRANGLE DR STE 500
CHAPEL HILL NC
27517-8281
US

IV. Provider business mailing address

1020 RANDOLPH CT
CARY NC
27511-4108
US

V. Phone/Fax

Practice location:
  • Phone: 888-849-7370
  • Fax:
Mailing address:
  • Phone: 415-819-5776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF07261464
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: