Provider Demographics
NPI:1952532830
Name:WONGSARNPIGOON, RATTIYA AMY (ANP-BC)
Entity Type:Individual
Prefix:
First Name:RATTIYA
Middle Name:AMY
Last Name:WONGSARNPIGOON
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:RATTIYA
Other - Middle Name:AMY
Other - Last Name:CHAMKASEM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP-BC
Mailing Address - Street 1:CAMPUS HEALTH SERVICES
Mailing Address - Street 2:JAMES A. TAYLOR BUILDING; 320 EMERGENCY ROOM DRIVE
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-0001
Mailing Address - Country:US
Mailing Address - Phone:919-966-2281
Mailing Address - Fax:919-966-0616
Practice Address - Street 1:CAMPUS HEALTH SERVICES
Practice Address - Street 2:JAMES A. TAYLOR BUILDING; 320 EMERGENCY ROOM DRIVE
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-0001
Practice Address - Country:US
Practice Address - Phone:919-966-2281
Practice Address - Fax:919-966-0616
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004464363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health