Healthcare Provider Details

I. General information

NPI: 1235057621
Provider Name (Legal Business Name): KELLIE CAPES DNP, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3643 N ROXBORO ST
DURHAM NC
27704-2702
US

IV. Provider business mailing address

2455 WHELEN DR
GRAHAM NC
27253-5427
US

V. Phone/Fax

Practice location:
  • Phone: 919-470-8494
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number434
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number224815
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: