Provider Demographics
NPI:1629211727
Name:SHIRES, MARGARET BRALLEY (NP)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:BRALLEY
Last Name:SHIRES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:MARGARET
Other - Middle Name:ELIZABETH
Other - Last Name:BRALLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:3975 ROBINSON RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NC
Mailing Address - Zip Code:28658-9715
Mailing Address - Country:US
Mailing Address - Phone:284-660-4668
Mailing Address - Fax:828-466-8862
Practice Address - Street 1:3975 ROBINSON RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NC
Practice Address - Zip Code:28658-9715
Practice Address - Country:US
Practice Address - Phone:284-660-4668
Practice Address - Fax:828-466-8862
Is Sole Proprietor?:No
Enumeration Date:2009-04-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004379363L00000X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology