Healthcare Provider Details

I. General information

NPI: 1407511934
Provider Name (Legal Business Name): ABIGAIL IRENE TEPPER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2021
Last Update Date: 10/31/2021
Certification Date: 10/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 ERWIN RD
DURHAM NC
27705-4699
US

IV. Provider business mailing address

235 INDIAN TRAIL RD
CHAPEL HILL NC
27514-1927
US

V. Phone/Fax

Practice location:
  • Phone: 919-684-8111
  • Fax:
Mailing address:
  • Phone: 919-357-1630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number295813
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: