Healthcare Provider Details

I. General information

NPI: 1780260703
Provider Name (Legal Business Name): MEGAN NICOLE MITTELMAN WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEGAN NICOLE MINTON WHNP-BC

II. Dates (important events)

Enumeration Date: 03/21/2021
Last Update Date: 04/04/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 DUKE HEALTH CARY PL STE 310
CARY NC
27519-6759
US

IV. Provider business mailing address

100 DUKE HEALTH CARY PL STE 310
CARY NC
27519-6759
US

V. Phone/Fax

Practice location:
  • Phone: 919-385-5200
  • Fax:
Mailing address:
  • Phone: 919-385-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number5014230
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: