Individual
KELLY ANTOINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3150 ROGERS RD STE 102, WAKE FOREST, NC 27587-4196
(502) 629-8828
Mailing address
6036 BALANCE CT, RALEIGH, NC 27616-4352
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2025-00757
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2022
Last updated
06/17/2025
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