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General NPI Number Information
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NPI Number | 1851253801
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Entity Type | Organization
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Legal Business Name | MILLENNIMED DIRECT PRIMARY CARE, PLLC
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Dates
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Enumeration Date | 11/28/2025
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Last Update Date | 11/28/2025
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Provider Practice Location Address
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Address Line | 604 VIGO COURT
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City | ROLESVILLE
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State | NC
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Zip | 27571
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Country | US
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Telephone | 919-410-8560
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Fax | 605-309-7805
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Provider Business Mailing Address
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Address Line | 9121 ANSON WAY STE 200
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City | RALEIGH
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State | NC
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Zip | 27615-5857
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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 | PRESIDENT & CHIEF EXECUTIVE OFFICER
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Name | MS. CHARLAMY MEGAN JONES
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Credential | NP
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Telephone | 919-841-2357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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