Healthcare Provider Details

I. General information

NPI: 1386281533
Provider Name (Legal Business Name): ELENA MCGINTY MSN, AOCNS, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2019
Last Update Date: 07/27/2021
Certification Date: 07/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 CREEKSHIRE WAY SUITE 270
WINSTON SALEM NC
27103
US

IV. Provider business mailing address

3719 BROWNSTONE LN
WINSTON SALEM NC
27106-3572
US

V. Phone/Fax

Practice location:
  • Phone: 336-701-3111
  • Fax: 888-757-4153
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5012590
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number424
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: