Healthcare Provider Details

I. General information

NPI: 1609108257
Provider Name (Legal Business Name): COURTNEY LEE RAWLS N.P., R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2010
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 E ALTON ST
DURHAM NC
27707-3005
US

IV. Provider business mailing address

314 E ALTON ST
DURHAM NC
27707-3005
US

V. Phone/Fax

Practice location:
  • Phone: 919-593-4407
  • Fax:
Mailing address:
  • Phone: 919-593-4407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5017008
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number5017008
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5017008
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: