MEDICARE: SILVER CREEK FAMILY PRACTICE, 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	:	1679039374
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SILVER CREEK FAMILY PRACTICE, PLLC

Provider Business Mailing Address
First Line	:	110 E MAIN ST
Second Line	:
City	:	MORGANTON
State	:	NC
Zip	:	28655-6040
Country	:	US
Telephone Number	:	828-608-2016
Fax Number	:	828-608-2029

Provider Business Practice Location Address
First Line	:	302 PITTS STREET
Second Line	:
City	:	MORGANTON
State	:	NC
Zip	:	28655-6040
Country	:	US
Telephone Number	:	828-608-2016
Fax Number	:	828-608-2029

Authorized Official
Title or Position	:	FAMILY NURSE PRACTITIONER
Name	:	LINDSEY MICHELLE MICHAELS
Credential	:	FNP
Telephone Number	:	828-608-2016

Provider Enumeration Date	:	02/18/2019
Last Update Date	:	12/21/2020

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