Healthcare Provider Details

I. General information

NPI: 1205759958
Provider Name (Legal Business Name): NATPAWEE SOMKANAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1507 DRAW BRIDGE LN
FAYETTEVILLE NC
28312-7673
US

IV. Provider business mailing address

1507 DRAW BRIDGE LN
FAYETTEVILLE NC
28312-7673
US

V. Phone/Fax

Practice location:
  • Phone: 910-546-9542
  • Fax:
Mailing address:
  • Phone: 910-546-9542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN1003X
TaxonomyNutrition Support Registered Nurse
License Number283572
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: