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General NPI Number Information
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NPI Number | 1790358281
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Entity Type | Individual
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Provider Name | KATELIN MALEY FNP
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Gender | Female
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Dates
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Enumeration Date | 07/21/2021
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Last Update Date | 07/21/2021
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Provider Practice Location Address
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Address Line | 3434 EDWARDS MILL RD
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City | RALEIGH
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State | NC
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Zip | 27612-4275
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Country | US
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Telephone | 919-608-1330
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Fax |
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Provider Business Mailing Address
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Address Line | 400 ECHO PARK PL
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City | APEX
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State | NC
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Zip | 27523-6110
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Country | US
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Telephone | 984-244-4805
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5014758
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License Number State | NC
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