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General NPI Number Information
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NPI Number | 1881161347
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Entity Type | Organization
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Legal Business Name | MH BLUE RIDGE MEDICAL CENTER, LLLP
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Dates
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Enumeration Date | 11/01/2018
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Last Update Date | 11/25/2019
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Provider Practice Location Address
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Address Line | 800 MEDICAL CAMPUS DR
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City | BURNSVILLE
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State | NC
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Zip | 28714-9010
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Country | US
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Telephone | 828-682-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 800 MEDICAL CAMPUS DR
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City | BURNSVILLE
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State | NC
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Zip | 28714-9010
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Country | US
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Telephone | 828-682-0200
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | LAURA D. BAILEY
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Credential | JD
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Telephone | 615-344-6215
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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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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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