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Individual

SHIBU EDWARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSN-AGNP-C

Contact information

Practice address
2301 ERWIN RD, DURHAM, NC 27705-4699
(919) 613-6133
Mailing address
1921 GRACE POINT RD, MORRISVILLE, NC 27560-6676
(919) 477-2937

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5010563
NC

Other

Enumeration date
06/04/2018
Last updated
06/04/2018
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