Provider Demographics
NPI:1790249605
Name:BERLIN, CAROLYN ANN (NP)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:ANN
Last Name:BERLIN
Suffix:
Gender:F
Credentials:NP
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Other - First Name:
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Mailing Address - Street 1:3600 NORTHWEST CARY PKWY. SUITE 104
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513
Mailing Address - Country:US
Mailing Address - Phone:919-319-9219
Mailing Address - Fax:919-481-1716
Practice Address - Street 1:3600 NORTHWEST CARY PKWY. SUITE 104
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513
Practice Address - Country:US
Practice Address - Phone:919-319-9219
Practice Address - Fax:919-481-1716
Is Sole Proprietor?:No
Enumeration Date:2019-01-24
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC5011366363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner