Provider Demographics
NPI:1669013777
Name:MESSINO, MICHELINA ELIZABETH (FNP)
Entity Type:Individual
Prefix:
First Name:MICHELINA
Middle Name:ELIZABETH
Last Name:MESSINO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1388 SAND HILL RD
Mailing Address - Street 2:
Mailing Address - City:CANDLER
Mailing Address - State:NC
Mailing Address - Zip Code:28715-8937
Mailing Address - Country:US
Mailing Address - Phone:828-213-5335
Mailing Address - Fax:828-213-5336
Practice Address - Street 1:1388 SAND HILL RD
Practice Address - Street 2:
Practice Address - City:CANDLER
Practice Address - State:NC
Practice Address - Zip Code:28715-8937
Practice Address - Country:US
Practice Address - Phone:828-213-5335
Practice Address - Fax:828-213-5336
Is Sole Proprietor?:No
Enumeration Date:2019-10-01
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5012057207Q00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1669013777Medicaid