Healthcare Provider Details

I. General information

NPI: 1245079268
Provider Name (Legal Business Name): DEVYN ALAISEA-ROOKH JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2024
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E 2ND ST
KENLY NC
27542-7794
US

IV. Provider business mailing address

120 N MEDICAL DRIVE UNC-CH-SON
CHAPEL HILL NC
27599-0001
US

V. Phone/Fax

Practice location:
  • Phone: 919-284-4025
  • Fax: 919-284-5965
Mailing address:
  • Phone: 919-966-4260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5022832
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: