=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235828229
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SURAYYAH BINT JAMES NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/04/2023
-----------------------------------------------------
Last Update Date | 01/21/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3019 FALSTAFF RD
-----------------------------------------------------
City | RALEIGH
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27610-1812
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-250-7600
-----------------------------------------------------
Fax | 919-250-6711
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 28 BRADFORD ST
-----------------------------------------------------
City | SMITHFIELD
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27577-9400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-280-6617
-----------------------------------------------------
Fax | 855-631-1029
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 5018067
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 5018061
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------