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Organization

WAKEMED SPECIALISTS GROUP LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KAREN REVICKI PERRY (EXEC DIRECTOR OPERATIONS)
(919) 350-8000
Entity
Organization

Contact information

Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-0554
Mailing address
PO BOX 808800, KANSAS CITY, MO 64180-8800
(877) 498-4490

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary

Other

Enumeration date
02/09/2026
Last updated
02/09/2026
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