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General NPI Number Information
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NPI Number | 1366226599
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Entity Type | Organization
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Legal Business Name | SYNERGY INNOVATIONS P.C.
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Dates
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Enumeration Date | 08/21/2023
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Last Update Date | 12/04/2023
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Provider Practice Location Address
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Address Line | 189 WIND CHIME CT STE 202
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City | RALEIGH
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State | NC
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Zip | 27615-6480
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Country | US
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Telephone | 919-873-4339
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Fax | 919-910-9967
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Provider Business Mailing Address
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Address Line | 6625 VESTAL ST
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City | WAKE FOREST
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State | NC
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Zip | 27587-9804
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Country | US
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Telephone | 402-214-3663
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIC NURSE PRACTITIONER
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Name | LEVINA KUMAR
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Credential | PMHNP-BC
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Telephone | 919-873-4339
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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