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General NPI Number Information
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NPI Number | 1528481553
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Entity Type | Individual
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Provider Name | ERIN O'MALLEY PHELPS P.A.-C
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Gender | Female
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Dates
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Enumeration Date | 01/28/2014
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 131 MILLER ST
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City | WINSTON SALEM
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State | NC
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Zip | 27103-2508
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Country | US
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Telephone | 336-716-8200
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Fax | 336-716-9841
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Provider Business Mailing Address
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Address Line | 100 KIMEL FOREST DR
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City | WINSTON SALEM
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State | NC
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Zip | 27103-6074
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0010-04790
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-04790
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License Number State | NC
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