Provider Demographics
NPI:1558819516
Name:MEGGITT, CORILIN NOCITO (ACNPC-AG)
Entity Type:Individual
Prefix:
First Name:CORILIN
Middle Name:NOCITO
Last Name:MEGGITT
Suffix:
Gender:F
Credentials:ACNPC-AG
Other - Prefix:
Other - First Name:CORILIN
Other - Middle Name:
Other - Last Name:NOCITO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4505 FAIR MEADOWS LN STE 102
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6449
Mailing Address - Country:US
Mailing Address - Phone:196-703-9399
Mailing Address - Fax:910-321-7245
Practice Address - Street 1:4505 FAIR MEADOWS LN STE 102
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607
Practice Address - Country:US
Practice Address - Phone:919-670-3939
Practice Address - Fax:984-200-6429
Is Sole Proprietor?:No
Enumeration Date:2016-09-19
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5008927363LA2100X, 363LG0600X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89014Y4Medicaid
2334998Medicare PIN
NC6086600001Medicare NSC
NC89014Y4Medicaid