Individual
MARY KATHRYN ELLEDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2301 ERWIN RD, DURHAM, NC 27705-4699
(919) 684-8111
Mailing address
6804 BUCKHEAD DR, RALEIGH, NC 27615-7003
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
297433
NC
363LP0200X
Pediatric Nurse Practitioner
Primary
5021780
NC
Other
Enumeration date
04/03/2023
Last updated
08/25/2025
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