Provider Demographics
NPI:1427210517
Name:MCLEOD, MARY DARDEN (NPC)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:DARDEN
Last Name:MCLEOD
Suffix:
Gender:F
Credentials:NPC
Other - Prefix:MS
Other - First Name:MARY DARDEN
Other - Middle Name:MCLEOD
Other - Last Name:LINEBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1890
Mailing Address - Street 2:321 MULBERRY STREET
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-1890
Mailing Address - Country:US
Mailing Address - Phone:828-757-5508
Mailing Address - Fax:828-757-6141
Practice Address - Street 1:321 MULBERRY ST SW
Practice Address - Street 2:EMPLOYEE FIRST CLINIC
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5720
Practice Address - Country:US
Practice Address - Phone:828-757-5508
Practice Address - Fax:828-757-6141
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC193347363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily