Healthcare Provider Details

I. General information

NPI: 1285301630
Provider Name (Legal Business Name): MARIA CATHERINE NEVILLE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2021
Last Update Date: 10/04/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 DUKE MEDICINE CIR
DURHAM NC
27710-4000
US

IV. Provider business mailing address

2 HIGHROCK CT
DURHAM NC
27713-8905
US

V. Phone/Fax

Practice location:
  • Phone: 919-681-3341
  • Fax:
Mailing address:
  • Phone: 814-602-7569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5020962
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number290799
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: