Healthcare Provider Details

I. General information

NPI: 1477894467
Provider Name (Legal Business Name): MICHELLE YOLANDA FEROLITO N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE YOLANDA FEROLITO N.P.

II. Dates (important events)

Enumeration Date: 03/15/2013
Last Update Date: 09/17/2021
Certification Date: 09/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N ELM ST
GREENSBORO NC
27401-1004
US

IV. Provider business mailing address

PO BOX 60447
CHARLOTTE NC
28260-0447
US

V. Phone/Fax

Practice location:
  • Phone: 336-832-2840
  • Fax:
Mailing address:
  • Phone: 336-718-7041
  • Fax: 336-718-9622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number21277
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5012794
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: