Healthcare Provider Details

I. General information

NPI: 1427085794
Provider Name (Legal Business Name): JAMES MACFARLAND NEBLETT III CRNA, MSN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 11/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 FULTON ST 112C
DURHAM NC
27705-3875
US

IV. Provider business mailing address

9505 MEADOWMONT LN
RALEIGH NC
27615-4067
US

V. Phone/Fax

Practice location:
  • Phone: 919-286-6938
  • Fax: 919-286-6853
Mailing address:
  • Phone: 919-845-3041
  • Fax: 919-286-6853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number156385
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: