| Mountain Park Family Practice, Pllc | |
|
90 E Main St Ste 2 Sylva NC 28779-3030 | |
| (828) 631-3181 | |
| (828) 631-6113 |
| Full Name | Mountain Park Family Practice, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 90 E Main St Ste 2, Sylva, North Carolina |
| Authorized Official Name and Position | Laura Miller (PROVIDER/ORGANIZER) |
| Authorized Official Contact | 8286313181 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Park Family Practice, Pllc 90 E Main St Ste 2 Sylva NC 28779-3030 Ph: (828) 631-3181 | Mountain Park Family Practice, Pllc 90 E Main St Ste 2 Sylva NC 28779-3030 Ph: (828) 631-3181 |
| NPI Number | 1730795493 |
|---|---|
| Provider Enumeration Date | 09/18/2020 |
| Last Update Date | 09/18/2020 |
| Medicare PECOS PAC ID | 5395157259 |
|---|---|
| Medicare Enrollment ID | O20201217001017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730795493 | NPI | - | NPPES |
| 1215377908 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Cheryl Nicholson Owen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235224692 PECOS PAC ID: 2668420464 Enrollment ID: I20050108000007 |
| Provider Name | Laura S Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215377908 PECOS PAC ID: 5395970347 Enrollment ID: I20170124000059 |
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