Healthcare Provider Details

I. General information

NPI: 1770898454
Provider Name (Legal Business Name): WOMEN'S HEALTH ALLIANCE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2010
Last Update Date: 08/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4414 LAKE BOONE TRL #300
RALEIGH NC
27607-7513
US

IV. Provider business mailing address

276 W MILLBROOK RD
RALEIGH NC
27609-4304
US

V. Phone/Fax

Practice location:
  • Phone: 919-781-5510
  • Fax: 919-781-5053
Mailing address:
  • Phone: 919-848-4080
  • Fax: 919-848-6376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. JUDY GARRETT
Title or Position: DIRECTOR
Credential:
Phone: 919-848-4080