Provider Demographics
NPI:1275815110
Name:MAY, AURELIE O (NP)
Entity Type:Individual
Prefix:
First Name:AURELIE
Middle Name:O
Last Name:MAY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 601067
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-1067
Mailing Address - Country:US
Mailing Address - Phone:704-667-3410
Mailing Address - Fax:704-667-3479
Practice Address - Street 1:1550 FAULK ST
Practice Address - Street 2:SUITE 3100
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-5086
Practice Address - Country:US
Practice Address - Phone:704-667-3410
Practice Address - Fax:704-667-3479
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC100442363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1275815110Medicaid
NCNC3735BMedicare PIN