Provider Demographics
NPI:1326875295
Name:MICHENFELDER, ABIGAIL (MSN, RN, AGNP-C)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:MICHENFELDER
Suffix:
Gender:F
Credentials:MSN, RN, AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2706 NEWQUAY ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-1628
Mailing Address - Country:US
Mailing Address - Phone:919-480-7847
Mailing Address - Fax:
Practice Address - Street 1:1390 CAPITAL BLVD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-1118
Practice Address - Country:US
Practice Address - Phone:919-836-1642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-16
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC271535163W00000X
NC5020933363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse