Healthcare Provider Details

I. General information

NPI: 1467356576
Provider Name (Legal Business Name): KIMYETTE SAUNDERS-BOUIE RN, CCM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5540 CENTERVIEW DR STE 200
RALEIGH NC
27606-3386
US

IV. Provider business mailing address

5540 CENTERVIEW DR STE 200
RALEIGH NC
27606-3386
US

V. Phone/Fax

Practice location:
  • Phone: 919-335-4301
  • Fax: 919-335-4302
Mailing address:
  • Phone: 919-335-4301
  • Fax: 919-335-4302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number207548
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: