Individual
DRISS ZINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(919) 784-3100
Mailing address
5 WEEPING BEECH WAY, DURHAM, NC 27713-4369
(919) 622-3978
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5013226
NC
363LA2200X
Adult Health Nurse Practitioner
Primary
5013226
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5013226
—
NC
Enumeration date
06/21/2020
Last updated
07/31/2020
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