Individual
MAGDALENE FINAN MUDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
205 PAGE RD, PINEHURST, NC 28374-8798
(910) 295-5511
(910) 235-3432
Mailing address
205 PAGE RD, PINEHURST, NC 28374-8798
(910) 295-5511
(910) 235-3443
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
201906
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7003655
—
NC
01
—
D9093
MEDCOST PROVIDER#
NC
01
—
FH4000450
FIRSTCAROLINACARE PROV.#
NC
01
—
NP0987
SC MEDICAID PROVIDER#
SC
01
—
P00300187
PALMETTO GOVT SERVICES
NC
Enumeration date
07/05/2006
Last updated
09/02/2009
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