Provider Demographics
NPI:1366558173
Name:SILVERNALE, MAUREEN CALLAHAN (FNP-C)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:CALLAHAN
Last Name:SILVERNALE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2413
Mailing Address - Street 2:
Mailing Address - City:YADKINVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27055-2413
Mailing Address - Country:US
Mailing Address - Phone:336-408-9704
Mailing Address - Fax:336-679-6752
Practice Address - Street 1:624 W MAIN ST
Practice Address - Street 2:
Practice Address - City:YADKINVILLE
Practice Address - State:NC
Practice Address - Zip Code:27055-7804
Practice Address - Country:US
Practice Address - Phone:336-679-2041
Practice Address - Fax:336-679-6752
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201046363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2809188BMedicare UPIN