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General NPI Number Information
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NPI Number | 1174430102
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Entity Type | Individual
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Provider Name | CARLIE SIMKUNAS
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Gender | Female
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Dates
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Enumeration Date | 08/25/2026
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Last Update Date | 08/25/2026
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Provider Practice Location Address
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Address Line | 4420 LAKE BOONE TRL
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City | RALEIGH
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State | NC
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Zip | 27607-7505
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Country | US
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Telephone | 919-784-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 8821 MELVIN ST
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City | WILLOW SPRING
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State | NC
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Zip | 27592-4601
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Country | US
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Telephone | 651-262-9730
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Fax |
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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 | 346471
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License Number State | NC
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