MEDICARE: ELENA MARY PROPST MBA

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	363AS0400X	Surgical Physician Assistant		NC
2	363AM0700X	Medical Physician Assistant		NC

General Provider Information

NPI Number	:	1598622441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELENA MARY PROPST MBA

Provider Business Mailing Address
First Line	:	102 MAPLE GROVE LN
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27703-6828
Country	:	US
Telephone Number	:	828-358-6598
Fax Number	:

Provider Business Practice Location Address
First Line	:	102 MAPLE GROVE LN
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27703-6828
Country	:	US
Telephone Number	:	828-358-6598
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

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Directions to “ ELENA MARY PROPST MBA” Practice Location

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