Healthcare Provider Details

I. General information

NPI: 1013835719
Provider Name (Legal Business Name): JULIE ANN MCCANCH FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 BUTTERNUT LN
CLAYTON NC
27520-5857
US

IV. Provider business mailing address

229 WEXFORD DR
CLAYTON NC
27520-5951
US

V. Phone/Fax

Practice location:
  • Phone: 919-359-1011
  • Fax:
Mailing address:
  • Phone: 412-585-5262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberF02260951
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: