# MOUNTAIN PARK FAMILY PRACTICE, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730795493
- **Authorized official:** LAURA MILLER FNP (PROVIDER/ORGANIZER)
- **Authorized official phone:** (828) 631-3181

## Contact information

- **Practice address:** 90 E MAIN ST STE 2, SYLVA, NC 28779-3030
- **Practice address phone:** (828) 631-3181
- **Practice address fax:** (828) 631-6113
- **Mailing address:** 90 E MAIN ST STE 2, SYLVA, NC 28779-3030
- **Mailing address phone:** (828) 631-3181
- **Mailing address fax:** (828) 631-6113

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/18/2020
- **Last updated:** 09/18/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1215377908 | — | NC |