Basic Information
| Provider Information | |||||||||
| NPI: | 1588790877 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MERRITT-JAMES | ||||||||
| FirstName: | PHYLLIS | ||||||||
| MiddleName: | ALETA | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3031 NEW BERN AVE | ||||||||
| Address2: | STE 306 | ||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276102989 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9192313966 | ||||||||
| FaxNumber: | 9192313912 | ||||||||
| Practice Location | |||||||||
| Address1: | 545 E MARKET ST | ||||||||
| Address2: | |||||||||
| City: | SMITHFIELD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275773923 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198767807 | ||||||||
| FaxNumber: | 9198768823 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2007 | ||||||||
| LastUpdateDate: | 04/28/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 201878 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.