Basic Information
Provider Information
NPI: 1184111866
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VARGHESE
FirstName: PRIYA
MiddleName: P
NamePrefix: MRS.
NameSuffix:  
Credential: NP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 507 N LINDSAY ST
Address2:  
City: HIGH POINT
State: NC
PostalCode: 272624303
CountryCode: US
TelephoneNumber: 3368830029
FaxNumber: 3368992176
Practice Location
Address1: 507 N LINDSAY ST
Address2:  
City: HIGH POINT
State: NC
PostalCode: 272624303
CountryCode: US
TelephoneNumber: 3368830029
FaxNumber: 3368992176
Other Information
ProviderEnumerationDate: 04/18/2018
LastUpdateDate: 04/18/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X221880NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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