Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 900453 | NC |
NPI | 1083096630 |
---|---|
Provider Name | Rebecca Kay Cicale |
First Address | Carrboro, NC 27510-1823 |
Second Address | Carrboro, NC 27510-1823 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2015 |
Last Update Date | 19/06/2015 |