Provider Demographics
NPI:1003949843
Name:MARKHAM, DEANNA GAY (NP)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:GAY
Last Name:MARKHAM
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:963 EDGE CT
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27205-7186
Mailing Address - Country:US
Mailing Address - Phone:336-629-1333
Mailing Address - Fax:
Practice Address - Street 1:500 ALBEMARLE RD
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-6257
Practice Address - Country:US
Practice Address - Phone:336-625-1172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC600073363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC600073OtherPRACTICE APPROVAL NUMBER-
NC600073OtherPRACTICE APPROVAL NUMBER-