Individual
KACIE MATTESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2301 ERWIN RD, DURHAM, NC 27705-4699
(919) 684-8111
Mailing address
4470 VILANA RDG APT 310, RALEIGH, NC 27612-4675
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
344697
NC
Other
Enumeration date
09/29/2025
Last updated
09/29/2025
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