Active NPI
Precious Wack, RN
- Registered Nurse
- Durham, NC
National Provider Identifier
1164183547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 302727
- Practice address
- 4104 Surles CT Ste 11
Durham, NC 27703-8239 - Phone
- (919) 790-0288
- NPI assigned
- Jan 6, 2022
- Last updated
- Jan 6, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 302727 | NC | Primary |
Addresses
Primary practice location
4104 Surles CT Ste 11
Durham, NC 27703-8239
Mailing address
4104 Surles CT Ste 11
Durham, NC 27703-8239
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 302727 | NC | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641427200000",
"number": "1164183547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4104 SURLES CT STE 11",
"city": "DURHAM",
"state": "NC",
"postal_code": "277038239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4104 SURLES CT STE 11",
"city": "DURHAM",
"state": "NC",
"postal_code": "277038239",
"telephone_number": "919-790-0288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WACK",
"first_name": "PRECIOUS",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-06",
"last_updated": "2022-01-06",
"certification_date": "2022-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NC",
"license": "302727",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.