Individual provider Active NPI

Christine A Wilzack, PMH-CNS, FNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Holly Springs, NC
National Provider Identifier
1356303796
Registry record updated Feb 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5006513 Issued in NC
Practice address
190 Rosewood Centre Dr
Holly Springs, NC 27540-7628
Phone
(919) 851-1527
Fax
(919) 851-3555
NPI assigned
Apr 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R104565 MD
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X R104565 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5006513 NC Primary

Addresses

Primary practice location

190 Rosewood Centre Dr
Holly Springs, NC 27540-7628

Mailing address

917 Old Baron Dr
Fuquay Varina, NC 27526-7000
Phone (919) 228-9020

Other practice location 1

201 E Academy St Ste 304
Fuquay Varina, NC 27526-2248
Phone (919) 228-9020

Other identifiers 1

IdentifierTypeStateIssuer
1356303796MedicaidMD

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)
Enrolled
Credentials
Certified Nurse Specialist, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Courage to Change Mental Health and Wellness PLLC Psychiatric/Mental Health CurrentSince Dec 14, 2025 Accepting new patients
Bay Life Services Corporation Past Accepting new patients
Orthopaedic Associates, PA Past Accepting new patients
Cary Physical Therapy and Rehabilitation Inc. PastSince Aug 18, 2020 Accepting new patients
Orthopaedic Associates, PA Past Accepting new patients
Bay Life Services Corporation Past Accepting new patients

Locations

201 E Academy St
Ste 304
Fuquay Varina, NC 27526
Phone (919) 228-9020

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770336000000",
    "number": "1356303796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 OLD BARON DR",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275267000",
            "telephone_number": "919-228-9020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 ROSEWOOD CENTRE DR",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275407628",
            "telephone_number": "919-851-1527",
            "fax_number": "919-851-3555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 E Academy St Ste 304",
            "address_purpose": "LOCATION",
            "city": "Fuquay Varina",
            "state": "NC",
            "postal_code": "275262248",
            "country_code": "US",
            "telephone_number": "919-228-9020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILZACK",
        "first_name": "CHRISTINE",
        "middle_name": "A",
        "credential": "PMH-CNS, FNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2026-02-06",
        "certification_date": "2026-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R104565",
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R104565",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5006513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356303796",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holly Springs, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.