Individual
MARY ELLEN PREVOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1511 WESTOVER TER, SUITE 201, GREENSBORO, NC 27408-7128
(336) 373-0611
Mailing address
1511 WESTOVER TER, SUITE 201, GREENSBORO, NC 27408-7128
(336) 373-0611
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
153275
NC
363L00000X
Nurse Practitioner
Primary
0050-00029
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZF0000184
—
NC
Enumeration date
03/02/2007
Last updated
04/11/2022
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