Healthcare Provider Details

I. General information

NPI: 1568886299
Provider Name (Legal Business Name): BRIAN CAPEL PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2014
Last Update Date: 02/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 EDWARDS MILL RD STE 141 #163
RALEIGH NC
27612-5371
US

IV. Provider business mailing address

3201 EDWARDS MILL RD STE 141 #163
RALEIGH NC
27612-5371
US

V. Phone/Fax

Practice location:
  • Phone: 919-443-2360
  • Fax: 919-800-3039
Mailing address:
  • Phone: 919-443-2360
  • Fax: 919-800-3039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024171458
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: