Basic Information
| Provider Information | |||||||||
| NPI: | 1316112923 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOLDEN | ||||||||
| FirstName: | MAUREEN | ||||||||
| MiddleName: | CONAGHAN | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1701 WESTCHESTER DR | ||||||||
| Address2: | STE 850 | ||||||||
| City: | HIGH POINT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272627254 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3368022000 | ||||||||
| FaxNumber: | 3368022534 | ||||||||
| Practice Location | |||||||||
| Address1: | 4431 HWY 220 N | ||||||||
| Address2: | |||||||||
| City: | SUMMERFIELD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 273589411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3366437711 | ||||||||
| FaxNumber: | 3366433047 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/24/2008 | ||||||||
| LastUpdateDate: | 01/13/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 200429 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 200429 | 01 | NC | LICENSE | OTHER |