Healthcare Provider Details

I. General information

NPI: 1073908745
Provider Name (Legal Business Name): RITA CAHOON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2015
Last Update Date: 03/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1309 NC 306 HWY S
GRANTSBORO NC
28529-9613
US

IV. Provider business mailing address

1309 NC 306 HWY S
GRANTSBORO NC
28529-9613
US

V. Phone/Fax

Practice location:
  • Phone: 252-671-7607
  • Fax:
Mailing address:
  • Phone: 252-671-7607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number72557
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: