Healthcare Provider Details

I. General information

NPI: 1184141897
Provider Name (Legal Business Name): CHRICAT GARRARD FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRICAT ANN SUCHY

II. Dates (important events)

Enumeration Date: 08/23/2017
Last Update Date: 03/30/2021
Certification Date: 03/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4207 LAKE BOONE TRL STE 200
RALEIGH NC
27607
US

IV. Provider business mailing address

5410 BAYSIDE CT
RALEIGH NC
27613-5800
US

V. Phone/Fax

Practice location:
  • Phone: 919-784-1410
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5009821
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: