Wall, Michelle Deanna
Wall, Michelle Deanna is an individual health care provider with primary practice located at 348 N South St , Mount Airy NC 27030-3532. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Wall, Michelle Deanna can be contacted via phone (336) 786-6945.Contact Information
Primary practice address
348 N South St
Mount Airy NC 27030-3532
Phone: (336) 786-6945
Fax: (336) 789-5782
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 103078 | North Carolina |
Profile Details
| NPI number | 1619195302 |
|---|---|
| LBN Legal business name | Wall, Michelle Deanna |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 20th, 2007 |
| Last updated | Jun 8th, 2009 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619195302 | NPPES |
| North Carolina | Other | 2291842C | MEDICARE GROUP/ORGANIZATION PTAN |
| North Carolina | Other | 2759201 | MEDICARE GROUP/ORGANIZATION PTAN |
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