Healthcare Provider Details

I. General information

NPI: 1134074792
Provider Name (Legal Business Name): COMMISSIONED HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2026
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 ARTILLERY LN
RALEIGH NC
27615-1507
US

IV. Provider business mailing address

108 ARTILLERY LN
RALEIGH NC
27615-1507
US

V. Phone/Fax

Practice location:
  • Phone: 252-432-0192
  • Fax:
Mailing address:
  • Phone: 252-432-0192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LAUREN DEANS WILLIAMS
Title or Position: MANAGING PARTNER
Credential: RN
Phone: 252-432-0192