Individual
BRENNA KATE HOULIHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3024 NEW BERN AVE STE 102, RALEIGH, NC 27610-1247
(919) 350-7331
Mailing address
PO BOX 603949, CHARLOTTE, NC 28260-3949
(919) 350-0351
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2021-02574
NC
208600000X
Surgery Physician
202102574
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053739870
—
NC
Enumeration date
03/29/2014
Last updated
10/12/2021
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