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General NPI Number Information
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NPI Number | 1750758991
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Entity Type | Individual
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Provider Name | ALIZA KAMMAN NEDIMYER MA, LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 08/24/2015
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Last Update Date | 09/12/2018
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Provider Practice Location Address
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Address Line | 101 ROCK HAVEN RD APT D402
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City | CARRBORO
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State | NC
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Zip | 27510-2578
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Country | US
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Telephone | 802-349-5343
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Fax |
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Provider Business Mailing Address
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Address Line | 2908 WHITE CROSS RD
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City | CHAPEL HILL
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State | NC
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Zip | 27516-5892
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Country | US
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Telephone | 802-349-5343
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2674
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | LAT-2674
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License Number State | NC
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