Provider Demographics
NPI:1376073494
Name:FOX, PAULA TROUTMAN (RN,GCC)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:TROUTMAN
Last Name:FOX
Suffix:
Gender:F
Credentials:RN,GCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1152 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OAKBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28129-9332
Mailing Address - Country:US
Mailing Address - Phone:980-354-1188
Mailing Address - Fax:
Practice Address - Street 1:1152 N MAIN ST
Practice Address - Street 2:
Practice Address - City:OAKBORO
Practice Address - State:NC
Practice Address - Zip Code:28129-9332
Practice Address - Country:US
Practice Address - Phone:980-354-1188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-13
Last Update Date:2017-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC98934163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse