Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 2008-01982 | NC |
Y | 207QA0401X | Family Doctor - Addiction Medicine | NC2008-01982 | NC |
N | 207RA0401X | Internist - Addiction Medicine | 2008-01982 | NC |
N | 207RS0012X | Sleep Medicine | 2008-01982 | NC |
NPI | 1366560872 |
---|---|
Provider Name | Dr. Jamila R. Battle |
First Address | Wake Forest, NC 27587 |
Second Address | Raleigh, NC 27615-4730 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 23/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5910881 | (05) | NC |