Healthcare Provider Details

I. General information

NPI: 1144629767
Provider Name (Legal Business Name): RACHEL KATHLEEN COLLINS CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL KATHLEEN WEINER CPNP-PC

II. Dates (important events)

Enumeration Date: 08/19/2014
Last Update Date: 09/09/2023
Certification Date: 09/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1655 WAKE DR UNIT 101
WAKE FOREST NC
27587-4746
US

IV. Provider business mailing address

1655 WAKE DR UNIT 101
WAKE FOREST NC
27587-4746
US

V. Phone/Fax

Practice location:
  • Phone: 195-564-7799
  • Fax: 919-556-5277
Mailing address:
  • Phone: 195-564-7799
  • Fax: 919-556-5277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number5018416
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: