Healthcare Provider Details

I. General information

NPI: 1255256996
Provider Name (Legal Business Name): TELKEVIA MACKEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4709 CREEKSTONE DR
DURHAM NC
27703-9822
US

IV. Provider business mailing address

2543 MERIDIAN PKWY APT 6201
DURHAM NC
27713-4228
US

V. Phone/Fax

Practice location:
  • Phone: 919-684-3730
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP25200
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: