Provider Demographics
NPI:1376968487
Name:MAZUREK, MAGGIE WHITT (FNP-C)
Entity type:Individual
Prefix:
First Name:MAGGIE
Middle Name:WHITT
Last Name:MAZUREK
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:MAGGIE
Other - Middle Name:LAUREN
Other - Last Name:WHITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2005 PISGAH CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-3309
Mailing Address - Country:US
Mailing Address - Phone:336-701-2662
Mailing Address - Fax:
Practice Address - Street 1:2005 PISGAH CHURCH RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455-3309
Practice Address - Country:US
Practice Address - Phone:336-701-2662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-26
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC246723363LF0000X
CA95000436363LF0000X
SC24007363LF0000X
NC5007328363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily