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NPI Code Detail

MEDICARE: MS. MICHELLE DUNLAP DEATON FNP

MEDICARE: MS. MICHELLE DUNLAP DEATON FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner5008048NC

General Provider Information

NPI Number : 1396115424
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MICHELLE DUNLAP DEATON FNP
Provider Business Mailing Address
First Line : 10130 PERIMETER PKWY STE 200
Second Line :
City : CHARLOTTE
State : NC
Zip : 28216-0197
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10130 PERIMETER PKWY STE 200
Second Line :
City : CHARLOTTE
State : NC
Zip : 28216-0197
Country : US
Telephone Number : 888-849-7379
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2015
Last Update Date : 10/01/2015

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