Healthcare Provider Details

I. General information

NPI: 1144691726
Provider Name (Legal Business Name): CAROLINA ROSSER DIMSDALE ACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2015
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 ERWIN ROAD
DURHAM NC
27710-5021
US

IV. Provider business mailing address

4008 STURBRIDGE DR
DURHAM NC
27713-8035
US

V. Phone/Fax

Practice location:
  • Phone: 919-681-7341
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number5005953
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number5005953
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: