Individual
MRS. TAMARA MAE IHENYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2220 CAPITAL BLVD, STE NO. 206, RALEIGH, NC 27609
(919) 803-3101
Mailing address
2220 CAPITAL BLVD, STE NO. 206, RALEIGH, NC 27609
(919) 803-3101
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HC4799
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HC4799
STATE OF NC LICENSE NO.
NC
Enumeration date
10/20/2015
Last updated
10/28/2015
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