Achamma M Abraham, FNP
Individual provider Active NPI Family Nurse Practitioner · Butner, NC
NPI 1124289871 · NPPES record last updated Jun 24, 2008
Key facts
- NPI
- 1124289871
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 5003989 (NC)
- Practice address
- 1003 12TH St
Butner, NC 27509-1626 - Phone
- (919) 575-7276
- Fax
- (919) 575-7418
- NPI assigned
- Jun 24, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150617000905 | NC | Order and Referring Only - Nurse Practitioner | 2163565524 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5003989 | NC | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 5003989 | NC | Yes |
Addresses
Primary practice location
1003 12TH St
Butner, NC 27509-1626
Mailing address
1003 12TH St
Butner, NC 27509-1626
Phone (919) 575-7276
Other providers in Butner, NC
All providers in Butner, NC · Family Nurse Practitioner in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.