Provider Demographics
NPI:1235777392
Name:MASON, MARCIA DINKLE (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:DINKLE
Last Name:MASON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1271 MEADOW ACRE RD
Mailing Address - Street 2:
Mailing Address - City:MONETA
Mailing Address - State:VA
Mailing Address - Zip Code:24121-5515
Mailing Address - Country:US
Mailing Address - Phone:540-597-9462
Mailing Address - Fax:
Practice Address - Street 1:1271 MEADOW ACRE RD
Practice Address - Street 2:
Practice Address - City:MONETA
Practice Address - State:VA
Practice Address - Zip Code:24121-5515
Practice Address - Country:US
Practice Address - Phone:540-597-9462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-19
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001102418163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse