MEDICARE: MOUNTAIN PARK MEDICAL AESTHETICS & WELLNESS, PLLC

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
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1437008471
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOUNTAIN PARK MEDICAL AESTHETICS & WELLNESS, PLLC

Provider Business Mailing Address
First Line	:	390 WALMART PLAZA
Second Line	:	SUITE D
City	:	SYLVA
State	:	NC
Zip	:	28779
Country	:	US
Telephone Number	:	828-820-2210
Fax Number	:	971-203-0914

Provider Business Practice Location Address
First Line	:	390 WALMART PLAZA
Second Line	:	SUITE D
City	:	SYLVA
State	:	NC
Zip	:	28779
Country	:	US
Telephone Number	:	828-820-2210
Fax Number	:	971-203-0914

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	LAURA MILLER
Credential	:	FNP
Telephone Number	:	828-820-2210

Provider Enumeration Date	:	01/23/2026
Last Update Date	:	01/23/2026

Similar Medicare Providers

1124342860 — DR. MEGAN WALD METCALF M.D.
Practice Location Address:

70 THE VILLAGE OVERLOOK
SYLVA, NC
28779-2742

Practice Phone: 828-631-1960
Practice Fax: 828-586-7904

1669348538 — KARLEY BRENNING HYATT
Practice Location Address:

1188 SKYLAND DR
SYLVA, NC
28779-8002

Practice Phone: 828-339-2273
Practice Fax:

1083571137 — MANDY LYNNE CUTSHAW FNP-BC
Practice Location Address:

90 E MAIN ST STE 2
SYLVA, NC
28779-3030

Practice Phone: 828-377-1114
Practice Fax: 828-377-1119

1558364729 — DR. CHARLES HAROLD BARRIER MD
Practice Location Address:

26 WESTCARE DR , SUITE 304
SYLVA, NC
28779-5290

Practice Phone: 828-586-9200
Practice Fax: 828-586-9903

1912900523 — LAWRENCE FRANCIS SUPIK MD
Practice Location Address:

80 HEALTHCARE DR , STE 203
SYLVA, NC
28779-5146

Practice Phone: 828-586-5531
Practice Fax: 828-586-5759

1407859044 — CLIFFORD EDWARD FAULL MD
Practice Location Address:

80 HEALTHCARE DR , STE 203
SYLVA, NC
28779-5146

Practice Phone: 828-586-5531
Practice Fax: 828-586-5759

Directions to “MOUNTAIN PARK MEDICAL AESTHETICS & WELLNESS, PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.