Healthcare Provider Details

I. General information

NPI: 1043836232
Provider Name (Legal Business Name): FELICIA ALSTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2020
Last Update Date: 06/23/2020
Certification Date: 06/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160A CHATHAM ST
SANFORD NC
27330
US

IV. Provider business mailing address

160A CHATHAM ST
SANFORD NC
27330
US

V. Phone/Fax

Practice location:
  • Phone: 919-289-4779
  • Fax: 919-292-0400
Mailing address:
  • Phone: 919-289-4779
  • Fax: 919-292-0400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: