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NPI Code Detail

MEDICARE: SADIE RUTH ABBOUD FNP

MEDICARE: SADIE RUTH ABBOUD FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP2300XPrimary Care Nurse Practitioner9324695FL
2363LF0000XFamily Nurse Practitioner5011232NC

General Provider Information

NPI Number : 1558767046
Entity Type Code : Individual
Provider Name (Legal Business Name) : SADIE RUTH ABBOUD FNP
Provider Business Mailing Address
First Line : 13304 LEESVILLE CHURCH RD
Second Line :
City : RALEIGH
State : NC
Zip : 27617-5206
Country : US
Telephone Number : 866-389-2727
Fax Number :
Provider Business Practice Location Address
First Line : 13304 LEESVILLE CHURCH RD
Second Line :
City : RALEIGH
State : NC
Zip : 27617-5206
Country : US
Telephone Number : 386-679-2956
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2014
Last Update Date : 01/03/2019

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