Provider Demographics
NPI:1427522895
Name:HERRING, MAULA CHRISTINE
Entity type:Individual
Prefix:
First Name:MAULA
Middle Name:CHRISTINE
Last Name:HERRING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 396
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-0396
Mailing Address - Country:US
Mailing Address - Phone:919-771-6313
Mailing Address - Fax:
Practice Address - Street 1:1 UNIVERSITY DR STE 7993
Practice Address - Street 2:
Practice Address - City:CULLOWHEE
Practice Address - State:NC
Practice Address - Zip Code:28723-9646
Practice Address - Country:US
Practice Address - Phone:919-771-6313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCYPYW14628498OtherNC STATE HEALTH PLAN