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NPI Code Detail

MEDICARE: MARISSA NICOLE CAPERILLA PA

MEDICARE: MARISSA NICOLE CAPERILLA PA
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
1363A00000XPhysician Assistant0010-13307NC
2363AM0700XMedical Physician Assistant
3363A00000XPhysician Assistant

General Provider Information

NPI Number : 1427734359
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISSA NICOLE CAPERILLA PA
Provider Business Mailing Address
First Line : PO BOX 60447
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-0447
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2475 HILLCREST CENTER CIR
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27103-3048
Country : US
Telephone Number : 336-754-3500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2023
Last Update Date : 10/31/2025

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Directions to “ MARISSA NICOLE CAPERILLA PA” Practice Location

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