Healthcare Provider Details

I. General information

NPI: 1003722299
Provider Name (Legal Business Name): RACHEL HORAN HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1954 S MAIN ST
WAKE FOREST NC
27587-9336
US

IV. Provider business mailing address

1954 S MAIN ST
WAKE FOREST NC
27587-9336
US

V. Phone/Fax

Practice location:
  • Phone: 919-570-8311
  • Fax: 919-573-0797
Mailing address:
  • Phone: 919-570-8311
  • Fax: 919-573-0797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number1755
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: