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NPI Code Detail

MEDICARE: MARY MCVEAN FNP

MEDICARE:   MARY  MCVEAN  FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner101-0014543VT
2363L00000XNurse Practitioner5007834NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083722623
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY MCVEAN FNP
Provider Business Mailing Address
First Line : 5107 N CROATAN HWY
Second Line :
City : KITTY HAWK
State : NC
Zip : 27949-3989
Country : US
Telephone Number : 252-441-7870
Fax Number : 252-565-0534
Provider Business Practice Location Address
First Line : 400 S CROATAN HWY
Second Line :
City : KILL DEVIL HILLS
State : NC
Zip : 27948-8895
Country : US
Telephone Number : 252-441-7870
Fax Number : 252-565-0534
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2006
Last Update Date : 12/16/2022

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