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General NPI Number Information
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NPI Number | 1750804423
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Entity Type | Individual
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Provider Name | MARIA DYER FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/24/2017
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Last Update Date | 11/09/2022
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Provider Practice Location Address
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Address Line | 4505 FAIR MEADOWS LN STE 215
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City | RALEIGH
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State | NC
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Zip | 27607-6449
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Country | US
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Telephone | 919-944-9935
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Fax |
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Provider Business Mailing Address
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Address Line | 4505 FAIR MEADOWS LN STE 215
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City | RALEIGH
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State | NC
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Zip | 27607-6449
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Country | US
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Telephone | 919-944-9935
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704281978
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704281978
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.022950
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5015545
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License Number State | NC
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