Healthcare Provider Details

I. General information

NPI: 1508745696
Provider Name (Legal Business Name): VOLHA KOSMOS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2025
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 FALLS OF NEUSE RD
RALEIGH NC
27614-7838
US

IV. Provider business mailing address

10000 FALLS OF NEUSE RD
RALEIGH NC
27614-7838
US

V. Phone/Fax

Practice location:
  • Phone: 919-631-7758
  • Fax: 919-350-7400
Mailing address:
  • Phone: 919-971-8604
  • Fax: 919-971-8604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number21700315
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: