Healthcare Provider Details

I. General information

NPI: 1083174742
Provider Name (Legal Business Name): HILDEGARDE MICHEL PERRY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2019
Last Update Date: 11/27/2023
Certification Date: 01/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3821 ED DR
RALEIGH NC
27612-8038
US

IV. Provider business mailing address

3821 ED DR
RALEIGH NC
27612-8038
US

V. Phone/Fax

Practice location:
  • Phone: 919-863-9441
  • Fax: 919-863-9443
Mailing address:
  • Phone: 919-863-9441
  • Fax: 919-863-9442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number233887
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5011717
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: