Provider Demographics
NPI:1710591748
Name:ALENA, AMY (DAC)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:
Last Name:ALENA
Suffix:
Gender:F
Credentials:DAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8202 HEATHFIELD DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3216
Mailing Address - Country:US
Mailing Address - Phone:910-233-5080
Mailing Address - Fax:
Practice Address - Street 1:160 MACGREGOR PINES DR STE 301
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-6037
Practice Address - Country:US
Practice Address - Phone:919-714-9828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1064171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist