Provider Demographics
NPI:1982677464
Name:TRUE, MARJORIE JEAN (FNP)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:JEAN
Last Name:TRUE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 249
Mailing Address - Street 2:
Mailing Address - City:YADKINVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27055-0249
Mailing Address - Country:US
Mailing Address - Phone:336-386-8270
Mailing Address - Fax:336-386-9831
Practice Address - Street 1:111 COMER ST
Practice Address - Street 2:
Practice Address - City:DOBSON
Practice Address - State:NC
Practice Address - Zip Code:27017-8724
Practice Address - Country:US
Practice Address - Phone:336-386-8270
Practice Address - Fax:336-386-9831
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201047363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCS51460Medicare UPIN
NC2596697EMedicare ID - Type UnspecifiedMEDICARE