Healthcare Provider Details

I. General information

NPI: 1326529454
Provider Name (Legal Business Name): CAROLINE HADLEY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2018
Last Update Date: 08/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

796 DOCTORS CT
ROXBORO NC
27573-4571
US

IV. Provider business mailing address

704 15TH ST APT 260
DURHAM NC
27705-3974
US

V. Phone/Fax

Practice location:
  • Phone: 336-598-0002
  • Fax:
Mailing address:
  • Phone: 150-873-7942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5010894
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: