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General NPI Number Information
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NPI Number | 1437925492
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Entity Type | Individual
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Provider Name | YAEWOON SONG
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Gender | Female
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Dates
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Enumeration Date | 11/30/2023
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Last Update Date | 04/21/2026
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Provider Practice Location Address
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Address Line | 1006 LAMOND AVE STE A
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City | DURHAM
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State | NC
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Zip | 27701-2074
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Country | US
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Telephone | 919-587-8018
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Fax | 919-275-5552
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Provider Business Mailing Address
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Address Line | 110 IOWA LN STE 204
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City | CARY
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State | NC
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Zip | 27511-2400
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Country | US
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Telephone | 336-314-5687
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 5022613
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 333852
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License Number State | NC
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