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General NPI Number Information
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NPI Number | 1700604584
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Entity Type | Individual
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Provider Name | CARRIE KONN FNP
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Gender | Female
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 916 W MORGAN ST
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City | RALEIGH
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State | NC
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Zip | 27603-1512
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Country | US
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Telephone | 919-782-3870
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Fax |
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Provider Business Mailing Address
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Address Line | 8940 WILLOW TRACE CT
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City | APEX
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State | NC
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Zip | 27539-6807
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Country | US
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Telephone | 203-521-2447
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5020755
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License Number State | NC
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