Provider Demographics
NPI:1407976855
Name:FOH, MARIAMA TEJAN SIE (RN, MSN, DNP)
Entity Type:Individual
Prefix:DR
First Name:MARIAMA
Middle Name:TEJAN SIE
Last Name:FOH
Suffix:
Gender:F
Credentials:RN, MSN, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 US HIGHWAY 220 N
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27358-9207
Mailing Address - Country:US
Mailing Address - Phone:336-643-7738
Mailing Address - Fax:
Practice Address - Street 1:1 CVS DR
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-6195
Practice Address - Country:US
Practice Address - Phone:336-644-7738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2019-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC142703163W00000X
NC5004649363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse