Provider Demographics
NPI:1508638552
Name:ENDARA, CARRIE (BSN, RN, CPNP-PC)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:ENDARA
Suffix:
Gender:F
Credentials:BSN, RN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 CANDIA LN
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-8810
Mailing Address - Country:US
Mailing Address - Phone:610-804-7943
Mailing Address - Fax:919-681-5507
Practice Address - Street 1:2301 ERWIN RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4699
Practice Address - Country:US
Practice Address - Phone:919-684-6994
Practice Address - Fax:919-681-5507
Is Sole Proprietor?:No
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5019041363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics