Provider Demographics
NPI:1649687989
Name:NARULA, BOZENA STASIAK (NP)
Entity type:Individual
Prefix:
First Name:BOZENA
Middle Name:STASIAK
Last Name:NARULA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:BOZENA
Other - Middle Name:ELWIRA
Other - Last Name:STASIAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:110 PRESTON EXECUTIVE DR
Mailing Address - Street 2:STE 100
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-8447
Mailing Address - Country:US
Mailing Address - Phone:919-852-3999
Mailing Address - Fax:919-378-9114
Practice Address - Street 1:3633 HARDEN RD STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-3369
Practice Address - Country:US
Practice Address - Phone:919-784-3402
Practice Address - Fax:919-784-6232
Is Sole Proprietor?:No
Enumeration Date:2014-07-18
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCF0614355363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily