Healthcare Provider Details

I. General information

NPI: 1134726599
Provider Name (Legal Business Name): MICHA SYTORIA KRIS LANIER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2020
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7850 BRIER CREEK PKWY STE 100
RALEIGH NC
27617-8900
US

IV. Provider business mailing address

4705 UNIVERSITY DR BLDG 700
DURHAM NC
27707-3489
US

V. Phone/Fax

Practice location:
  • Phone: 919-748-4878
  • Fax: 919-748-4876
Mailing address:
  • Phone: 919-237-1337
  • Fax: 866-538-4716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-12253
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: