Healthcare Provider Details

I. General information

NPI: 1013666536
Provider Name (Legal Business Name): ADRIANE M CUTHBERT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2022
Last Update Date: 05/06/2022
Certification Date: 05/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5041 NEW CENTRE DR
WILMINGTON NC
28403-1680
US

IV. Provider business mailing address

1414 PHYSICIANS DR
WILMINGTON NC
28401-7335
US

V. Phone/Fax

Practice location:
  • Phone: 919-301-3200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF03220159
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number268451
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: