Healthcare Provider Details

I. General information

NPI: 1881284271
Provider Name (Legal Business Name): CARLY ROSE DUNN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2021
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

442 WOODBURN RD
RALEIGH NC
27605-1324
US

IV. Provider business mailing address

106 CITRINE CT
KNIGHTDALE NC
27545-7272
US

V. Phone/Fax

Practice location:
  • Phone: 888-663-6331
  • Fax:
Mailing address:
  • Phone: 919-633-5550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberDUNN-SFO97
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: