Individual
REBECCA K DALLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1655 WAKE DRIVE, SUITE 101, WAKE FOREST, NC 27587-4746
(919) 556-4779
(919) 556-5277
Mailing address
1655 WAKE DRIVE, SUITE 101, WAKE FOREST, NC 27587-4746
(919) 556-4779
(919) 556-5277
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
5006981
NC
Other
Enumeration date
10/10/2014
Last updated
10/10/2014
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