Healthcare Provider Details

I. General information

NPI: 1588363055
Provider Name (Legal Business Name): HILDA ADRIANA SANDOVAL VELIZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2023
Last Update Date: 09/29/2026
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7361 SIX FORKS RD
RALEIGH NC
27615-6162
US

IV. Provider business mailing address

7361 SIX FORKS RD STE 119
RALEIGH NC
27615-6162
US

V. Phone/Fax

Practice location:
  • Phone: 919-923-9040
  • Fax:
Mailing address:
  • Phone: 919-923-9040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number338111
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: