Provider Demographics
NPI:1720381874
Name:MAVELLIA, HELEN MARIE (NP)
Entity Type:Individual
Prefix:MRS
First Name:HELEN
Middle Name:MARIE
Last Name:MAVELLIA
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Gender:F
Credentials:NP
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Mailing Address - Street 1:15806 BROOKWAY DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-3237
Mailing Address - Country:US
Mailing Address - Phone:704-766-1000
Mailing Address - Fax:704-766-1002
Practice Address - Street 1:15806 BROOKWAY DR
Practice Address - Street 2:SUITE 400
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-3237
Practice Address - Country:US
Practice Address - Phone:704-766-1000
Practice Address - Fax:704-766-1002
Is Sole Proprietor?:No
Enumeration Date:2010-12-13
Last Update Date:2013-06-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC5005007363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health