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NPI Code Detail

MEDICARE: MISS ELYSHIA MICHELLE WARDEN PA-C

MEDICARE: MISS ELYSHIA MICHELLE WARDEN PA-C
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
1363AM0700XMedical Physician Assistant0010-00542NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10010-00542OTHERNCNC MEDICAL BOARD

General Provider Information

NPI Number : 1568572279
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS ELYSHIA MICHELLE WARDEN PA-C
Provider Business Mailing Address
First Line : 4010 MENDENHALL OAKS PKWY
Second Line :
City : HIGH POINT
State : NC
Zip : 27265-8076
Country : US
Telephone Number : 336-887-3195
Fax Number : 336-887-3194
Provider Business Practice Location Address
First Line : 4010 MENDENHALL OAKS PKWY
Second Line :
City : HIGH POINT
State : NC
Zip : 27265-8076
Country : US
Telephone Number : 336-887-3195
Fax Number : 336-887-3194
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 03/24/2021

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Directions to “ MISS ELYSHIA MICHELLE WARDEN PA-C” Practice Location

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