Healthcare Provider Details

I. General information

NPI: 1528369451
Provider Name (Legal Business Name): MICHELLE MARY BUMGARDNER FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE MARY MCNALLY FNP-BC

II. Dates (important events)

Enumeration Date: 11/09/2010
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6330 QUADRANGLE DR STE 500
CHAPEL HILL NC
27517-8281
US

IV. Provider business mailing address

6330 QUADRANGLE DR STE 500
CHAPEL HILL NC
27517-8281
US

V. Phone/Fax

Practice location:
  • Phone: 888-849-7379
  • Fax:
Mailing address:
  • Phone: 888-849-7379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12400
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024193855
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP031667
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71016895A
License Number StateIN
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4040065
License Number StateKY
# 6
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5022604
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: