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General NPI Number Information
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NPI Number | 1831982305
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Entity Type | Individual
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Provider Name | KARTHIKA PANNEERSELVAM
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Gender | Female
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Dates
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Enumeration Date | 05/27/2025
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 3400 WAKE FOREST RD
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City | RALEIGH
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State | NC
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Zip | 27609-7317
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Country | US
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Telephone | 919-954-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 612 LONG LAKE DR
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City | FUQUAY VARINA
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State | NC
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Zip | 27526-3761
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Country | US
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Telephone | 402-305-5452
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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 | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 361650
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License Number State | NC
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