Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 1474 | NC |
N | 226300000X | Kinesiotherapist | 1474 | NC |
NPI | 1912220054 |
---|---|
Provider Name | Dr. Nina Elshiekh Crego |
First Address | Durham, NC 27703-7710 |
Second Address | Durham, NC 27703-7710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2010 |
Last Update Date | 16/11/2012 |