MEDICARE: MRS. MICHELLE MERCER CANFIELD RN MSN 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
1	363LF0000X	Family Nurse Practitioner	201872	NC

General Provider Information

NPI Number	:	1417947334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MICHELLE MERCER CANFIELD RN MSN FNP

Provider Business Mailing Address
First Line	:	3404 WAKE FOREST RD STE 303
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-7341
Country	:	US
Telephone Number	:	919-931-6795
Fax Number	:

Provider Business Practice Location Address
First Line	:	3403 WAKE FOREST ROAD SUITE 303
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609
Country	:	US
Telephone Number	:	919-862-5480
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2005
Last Update Date	:	12/08/2025

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