Provider Demographics
NPI:1669229019
Name:SIS YOUR UTERUS MATTERS
Entity type:Organization
Organization Name:SIS YOUR UTERUS MATTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITAN
Authorized Official - Prefix:
Authorized Official - First Name:NEIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAUPHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-342-8361
Mailing Address - Street 1:PO BOX 1412
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27602-1412
Mailing Address - Country:US
Mailing Address - Phone:919-527-5432
Mailing Address - Fax:
Practice Address - Street 1:2920 FORESTVILLE RD STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-8774
Practice Address - Country:US
Practice Address - Phone:919-342-8361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service