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General NPI Number Information
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NPI Number | 1154112274
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Entity Type | Organization
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Legal Business Name | CAROLINA HEALTH ASSOCIATES PC
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Dates
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Enumeration Date | 05/16/2025
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Last Update Date | 04/02/2026
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Provider Practice Location Address
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Address Line | 1817 GENTLE BEND WAY
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City | FAYETTEVILLE
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State | NC
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Zip | 28314-6283
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Country | US
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Telephone | 910-224-5636
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Fax | 910-224-5636
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Provider Business Mailing Address
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Address Line | 1817 GENTLE BEND WAY
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City | FAYETTEVILLE
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State | NC
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Zip | 28314-6283
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Country | US
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Telephone | 910-224-5636
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Fax | 910-224-5636
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Authorized Official
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Title or Position | CEO
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Name | DR. MICHELLE MACK
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Credential | DNP FNP-C
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Telephone | 910-224-5636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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