Individual
MIRIAM PALEY THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
2131 S 17TH ST, WILMINGTON, NC 28401-7407
(910) 667-7000
(910) 815-5850
Mailing address
PO BOX 936857, ATLANTA, GA 31193-6857
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
202113644RN
OR
363L00000X
Nurse Practitioner
Primary
5013022
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
202203358NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14645493
CAQH ID
—
05
—
500805440
—
OR
Enumeration date
03/21/2020
Last updated
03/14/2023
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