| Rising Integrative Healthcare Of Wilmington, Pllc | |
|
5 Silva Terra Dr Ste 100 Wilmington NC 28412-2373 | |
| (910) 530-3031 | |
| Not Available |
| Full Name | Rising Integrative Healthcare Of Wilmington, Pllc |
|---|---|
| Speciality | General Practice |
| Location | 5 Silva Terra Dr Ste 100, Wilmington, North Carolina |
| Authorized Official Name and Position | Brian M Kean (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 9105303031 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rising Integrative Healthcare Of Wilmington, Pllc 504 Red Banks Rd Ste C Greenville NC 27858-5766 Ph: (252) 321-3579 | Rising Integrative Healthcare Of Wilmington, Pllc 5 Silva Terra Dr Ste 100 Wilmington NC 28412-2373 Ph: (910) 530-3031 |
| NPI Number | 1033776323 |
|---|---|
| Provider Enumeration Date | 05/22/2019 |
| Last Update Date | 07/31/2023 |
| Medicare PECOS PAC ID | 7618307596 |
|---|---|
| Medicare Enrollment ID | O20200416000693 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033776323 | NPI | - | NPPES |
| 200301497 | Other | NC | NC MEDICAL BOARD LICENSE |
| Provider Name | Courtney W Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043309198 PECOS PAC ID: 2668426768 Enrollment ID: I20050311000148 |
| Provider Name | Larry Terrell Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134121221 PECOS PAC ID: 9032165121 Enrollment ID: I20110606000760 |
| Provider Name | Harrison Gabriel Frank |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518143460 PECOS PAC ID: 1759554298 Enrollment ID: I20111028000603 |
| Provider Name | Valerie Cousins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932332376 PECOS PAC ID: 9830215102 Enrollment ID: I20161003002574 |
| Provider Name | Herman A Allison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578070843 PECOS PAC ID: 9133150253 Enrollment ID: I20180416002375 |
| Provider Name | Kyle Bryant Mccann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043883903 PECOS PAC ID: 3779979943 Enrollment ID: I20220415001143 |
| Provider Name | Kelcie Renae Willis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457015703 PECOS PAC ID: 0446630958 Enrollment ID: I20220630000328 |
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