Healthcare Provider Details

I. General information

NPI: 1497545602
Provider Name (Legal Business Name): AMY CARDENAS MA, NBC-HWC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2025
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 MINE LAKE CT STE 200
RALEIGH NC
27615-6417
US

IV. Provider business mailing address

112 CROSSWOOD DR
DURHAM NC
27703-2910
US

V. Phone/Fax

Practice location:
  • Phone: 919-344-1288
  • Fax:
Mailing address:
  • Phone: 919-344-1288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: