Healthcare Provider Details

I. General information

NPI: 1891699575
Provider Name (Legal Business Name): ALYSSA MORELL WEAVER HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4206 N ROXBORO ST STE 110
DURHAM NC
27704-1868
US

IV. Provider business mailing address

580 HOWARD AVE
SOMERSET NJ
08873-1113
US

V. Phone/Fax

Practice location:
  • Phone: 919-477-2040
  • Fax: 919-789-9560
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number1760
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: