Provider Demographics
NPI:1154919488
Name:PARATHATTAL, PREETHA KURIAS
Entity type:Individual
Prefix:
First Name:PREETHA
Middle Name:KURIAS
Last Name:PARATHATTAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PREETHA
Other - Middle Name:
Other - Last Name:KURIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1209 HILL HOLLOW WAY
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27523-3712
Mailing Address - Country:US
Mailing Address - Phone:919-455-3436
Mailing Address - Fax:
Practice Address - Street 1:1001 ROCK QUARRY RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-3825
Practice Address - Country:US
Practice Address - Phone:919-833-3111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-03
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5013940363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily