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General NPI Number Information
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NPI Number | 1144109661
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Entity Type | Individual
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Provider Name | MICHELE ELISE BRAKE APRN, ACCNS-AG
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Gender | Female
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Dates
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Enumeration Date | 08/28/2025
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 1900 KILDAIRE FARM RD
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City | CARY
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State | NC
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Zip | 27518-6616
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Country | US
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Telephone | 919-350-2603
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Fax |
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Provider Business Mailing Address
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Address Line | 500 CANON GATE DR
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City | CARY
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State | NC
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Zip | 27518-2978
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Country | US
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Telephone | 919-244-6217
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Fax | 919-244-6217
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 189789
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | 596
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License Number State | NC
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