Provider Demographics
NPI:1265419873
Name:NUECHTERLEIN, ANNE MARIE (PHD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:MARIE
Last Name:NUECHTERLEIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 TYNEMOUTH DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-5580
Mailing Address - Country:US
Mailing Address - Phone:919-387-9545
Mailing Address - Fax:919-677-0071
Practice Address - Street 1:407 TYNEMOUTH DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-5580
Practice Address - Country:US
Practice Address - Phone:919-387-9545
Practice Address - Fax:919-677-0071
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLPC1400101YP2500X
NCLMFT541106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC132NXOtherBCBS