Individual
MRS. CHARITA RENNEY MONTGOMERY BIVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2901 BLUE RIDGE RD STE 100, RALEIGH, NC 27607-6423
(919) 784-3018
(919) 784-1473
Mailing address
2901 BLUE RIDGE RD STE 100, RALEIGH, NC 27607-6423
(919) 784-3018
(919) 784-1473
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-07152
NC
Other
Enumeration date
07/05/2017
Last updated
08/10/2022
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