Provider Demographics
NPI:1558323568
Name:MARSHBURN, NORMA JANE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:NORMA
Middle Name:JANE
Last Name:MARSHBURN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:NORMA
Other - Middle Name:NEWTON
Other - Last Name:WILKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 639
Mailing Address - Street 2:
Mailing Address - City:ROSE HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28458-0639
Mailing Address - Country:US
Mailing Address - Phone:910-289-3027
Mailing Address - Fax:910-289-2894
Practice Address - Street 1:600 SOUTH SYCAMORE STREET
Practice Address - Street 2:
Practice Address - City:ROSE HILL
Practice Address - State:NC
Practice Address - Zip Code:28458
Practice Address - Country:US
Practice Address - Phone:910-289-3027
Practice Address - Fax:910-289-2894
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200539363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
S44263Medicare UPIN