Provider Demographics
NPI:1720568660
Name:CAPE FEAR HEALTH & WELLNESS, PLLC
Entity Type:Organization
Organization Name:CAPE FEAR HEALTH & WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:STANLEY
Authorized Official - Last Name:CARTE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, A/GNP-C
Authorized Official - Phone:910-367-5994
Mailing Address - Street 1:3333 WRIGHTSVILLE AVE UNIT G
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-4115
Mailing Address - Country:US
Mailing Address - Phone:910-367-5994
Mailing Address - Fax:844-523-8911
Practice Address - Street 1:3333 WRIGHTSVILLE AVE UNIT G
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-4115
Practice Address - Country:US
Practice Address - Phone:910-367-5994
Practice Address - Fax:844-523-8911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-20
Last Update Date:2019-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC172823363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1285032979Medicaid