Provider Demographics
NPI:1780260703
Name:MITTELMAN, MEGAN NICOLE (WHNP-BC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:NICOLE
Last Name:MITTELMAN
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:NICOLE
Other - Last Name:MINTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WHNP-BC
Mailing Address - Street 1:100 DUKE HEALTH CARY PL STE 310
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-6759
Mailing Address - Country:US
Mailing Address - Phone:919-385-5200
Mailing Address - Fax:
Practice Address - Street 1:100 DUKE HEALTH CARY PL STE 310
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-6759
Practice Address - Country:US
Practice Address - Phone:919-385-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-21
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5014230363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health