Individual
DR. CORTNEY LYNN MOUILLESSEAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
270 HORIZON DR, RALEIGH, NC 27615-4922
(919) 845-0623
(919) 488-1716
Mailing address
260 HORIZON DR, RALEIGH, NC 27615-4922
(919) 488-0015
(919) 277-0066
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
201101853
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5921418
—
NC
Enumeration date
08/01/2007
Last updated
08/12/2015
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