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General NPI Number Information
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NPI Number | 1184143224
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Entity Type | Organization
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Legal Business Name | RELIEF INTEGRATED HEALTHCARE
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Dates
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Enumeration Date | 09/10/2017
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Last Update Date | 09/10/2017
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Provider Practice Location Address
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Address Line | 109 JOLLY ST
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City | LOUISBURG
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State | NC
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Zip | 27549-2239
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Country | US
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Telephone | 919-791-7745
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Fax |
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Provider Business Mailing Address
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Address Line | 3213 JESELLA DR
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City | RALEIGH
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State | NC
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Zip | 27610-5556
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Country | US
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Telephone | 919-422-2359
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. CONNIE HICKS
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Credential | DNP, NP, D-PMHNP
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Telephone | 919-422-2359
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5004262
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 5004262
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License Number State | NC
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