Yolanda McClam Nicholson, FNP-C
Individual provider Active NPI Nurse Practitioner · Greensboro, NC
NPI 1609185255 · NPPES record last updated Jun 14, 2019
Key facts
- NPI
- 1609185255
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 5004898 (NC)
- Practice address
- 112 N Benbow Road
Greensboro, NC 27411-7299 - Phone
- (336) 285-2906
- Fax
- (336) 256-2613
- NPI assigned
- Sep 30, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5004898 | NC | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advance Family and Sports Medicine Center, PLLC | Current |
Accepting new patients |
Locations
3 Hatley Rd
Belfast, ME 04915
Phone (800) 868-1792
1000 Southpark Blvd
Ste A
Winston Salem, NC 27127
Phone (336) 788-4545
Interoperability endpoints
- https://api.platform.athenahealth.com/8874/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 5004898 | NC | Yes |
Addresses
Primary practice location
112 N Benbow Road
Greensboro, NC 27411-7299
Mailing address
1701 Westchester Dr
Ste. 850
High Point, NC 27262-7008
Phone (336) 802-2400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2595054 | Other | NC | PTAN MEDICARE |
Other names
- Yolanda Renee McClam
Other providers in Greensboro, NC
- Mary Nash Nichols
- Thomas Nichols Jr.
- Tonya Smith Nichols
- Ashley Elizabeth Nicholson
- Karen Day Nicholson
- Lauren Nickerson
- Stacey Nickerson
- Kristie Jordan Nicks
- Erin Nicol
- Debra Yvonne Nicoli
All providers in Greensboro, NC · Nurse Practitioner in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.