Healthcare Provider Details

I. General information

NPI: 1891613428
Provider Name (Legal Business Name): IKRAN ALI DNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 GLENWOOD AVE
RALEIGH NC
27612-7133
US

IV. Provider business mailing address

6800 GLENWOOD AVE
RALEIGH NC
27612-7133
US

V. Phone/Fax

Practice location:
  • Phone: 919-235-1939
  • Fax:
Mailing address:
  • Phone: 919-235-1939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5024840
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: