Healthcare Provider Details

I. General information

NPI: 1710864426
Provider Name (Legal Business Name): LOUINES BREDY PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2025
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10901 WORLD TRADE BLVD
RALEIGH NC
27617-4203
US

IV. Provider business mailing address

501 SWEET PINE LN
KNIGHTDALE NC
27545-6683
US

V. Phone/Fax

Practice location:
  • Phone: 919-746-8900
  • Fax:
Mailing address:
  • Phone: 919-648-3689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number309458
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5022934
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: