Healthcare Provider Details

I. General information

NPI: 1992637433
Provider Name (Legal Business Name): COREY LEMANT GATLING RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2530 MERIDIAN PKWY
DURHAM NC
27713-5272
US

IV. Provider business mailing address

1107 SANDTRAP WAY
DURHAM NC
27703-6588
US

V. Phone/Fax

Practice location:
  • Phone: 919-907-1262
  • Fax:
Mailing address:
  • Phone: 919-907-1262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number224857
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code163WH0500X
TaxonomyHemodialysis Registered Nurse
License Number224857
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code163WN0300X
TaxonomyNephrology Registered Nurse
License Number224857
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: