Individual provider Active NPI

Rosa Elena Mikle, NP

  • Family Nurse Practitioner
  • Durham, NC
National Provider Identifier
1447924766
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5015193 Issued in NC
Practice address
3573 Hillsborough Rd
Durham, NC 27705-2916
Phone
(919) 383-4611
NPI assigned
Aug 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5015193 NC Primary

Addresses

Primary practice location

3573 Hillsborough Rd
Durham, NC 27705-2916

Mailing address

2021 Terri Creek Dr
Fuquay Varina, NC 27526-5329

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1447924766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 TERRI CREEK DR",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275265329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3573 HILLSBOROUGH RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277052916",
            "telephone_number": "919-383-4611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKLE",
        "first_name": "ROSA",
        "middle_name": "ELENA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-02",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5015193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.