Healthcare Provider Details

I. General information

NPI: 1114868718
Provider Name (Legal Business Name): CAPITAL HEALING LIFESTYLE MEDICINE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1502 W. NC-54 HWY. SUITE 405
DURHAM NC
27707
US

IV. Provider business mailing address

1502 W. NC-54 HWY. SUITE 405
DURHAM NC
27707
US

V. Phone/Fax

Practice location:
  • Phone: 614-214-6029
  • Fax:
Mailing address:
  • Phone: 614-214-6029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: ANGELA RENEE LIPSCOMB-HUDSON
Title or Position: OWNER/MEDICAL DOCTOR
Credential: MD
Phone: 614-214-6029