Basic Information
| Provider Information | |||||||||
| NPI: | 1467037614 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | IRWIN | ||||||||
| FirstName: | HOPE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1532 SUNBOW FALLS LN APT 304 | ||||||||
| Address2: | |||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276098112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7194681897 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4350 US 421 S | ||||||||
| Address2: | |||||||||
| City: | LILLINGTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275466760 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9108931210 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2021 | ||||||||
| LastUpdateDate: | 10/26/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 363A00000X | 0110008076 | VA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.