Individual
PHANICE NANCY KEBASO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-6835
Mailing address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5011436
NC
Other
Enumeration date
01/18/2019
Last updated
02/27/2019
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