Provider Demographics
NPI:1821663386
Name:EGAN, ANNE MARIE (AUD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:EGAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:MARIE
Other - Last Name:MISEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4102 SETTLEMENT DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-9152
Mailing Address - Country:US
Mailing Address - Phone:414-708-9780
Mailing Address - Fax:
Practice Address - Street 1:4701 CREEDMOOR RD STE 111
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-4500
Practice Address - Country:US
Practice Address - Phone:919-256-2898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14856231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist