Provider Demographics
NPI:1366226599
Name:SYNERGY INNOVATIONS P.C.
Entity type:Organization
Organization Name:SYNERGY INNOVATIONS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:LEVINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:919-873-4339
Mailing Address - Street 1:6625 VESTAL ST
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-9804
Mailing Address - Country:US
Mailing Address - Phone:402-214-3663
Mailing Address - Fax:
Practice Address - Street 1:189 WIND CHIME CT STE 202
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6480
Practice Address - Country:US
Practice Address - Phone:919-873-4339
Practice Address - Fax:919-910-9967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-21
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty