Healthcare Provider Details

I. General information

NPI: 1487952800
Provider Name (Legal Business Name): LINDA MEZZA WOOLEY AGPCNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2011
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 NEW HANOVER MEDICAL PARK DR
WILMINGTON NC
28403-5345
US

IV. Provider business mailing address

PO BOX 60447
CHARLOTTE NC
28260-0447
US

V. Phone/Fax

Practice location:
  • Phone: 910-662-9300
  • Fax:
Mailing address:
  • Phone: 910-721-4230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5019851
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number5019851
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number112644
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: