Healthcare Provider Details

I. General information

NPI: 1689544785
Provider Name (Legal Business Name): FELICIA WHITAKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2025
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2421 TIMBER DR
RALEIGH NC
27604-2248
US

IV. Provider business mailing address

5701 FOREST POINT RD
RALEIGH NC
27610-6053
US

V. Phone/Fax

Practice location:
  • Phone: 919-576-9175
  • Fax: 855-515-4106
Mailing address:
  • Phone: 919-576-9175
  • Fax: 855-515-4106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: