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Organization

WAKE NEPHROLOGY ASSOCIATES, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. JAMIE KENDRA FRICKE (PRACTICE MANAGER)
(919) 876-7807
Entity
Organization

Contact information

Practice address
3604 BUSH ST, RALEIGH, NC 27609-7511
(919) 876-7807
(919) 876-8823
Mailing address
3604 BUSH ST, RALEIGH, NC 27609-7511
(919) 876-7807
(919) 876-8823

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
200100423
NC
174400000X
Specialist
200200682
NC
174400000X
Specialist
23533
NC
174400000X
Specialist
23576
NC
174400000X
Specialist
31375
NC
174400000X
Specialist
34410
NC
174400000X
Specialist
9500252
NC
174400000X
Specialist
Primary
9800209
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6973447
NC
05
7902997
NC
05
8947988
NC
Enumeration date
06/01/2005
Last updated
03/23/2011
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