Provider Demographics
NPI:1801051032
Name:MARION, JENNIFER COE (ANP-BC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:COE
Last Name:MARION
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 CHATHAM MEDICAL PARK
Mailing Address - Street 2:
Mailing Address - City:ELKIN
Mailing Address - State:NC
Mailing Address - Zip Code:28621-2481
Mailing Address - Country:US
Mailing Address - Phone:336-835-3136
Mailing Address - Fax:336-835-6038
Practice Address - Street 1:500 CHATHAM MEDICAL PARK
Practice Address - Street 2:
Practice Address - City:ELKIN
Practice Address - State:NC
Practice Address - Zip Code:28621-2481
Practice Address - Country:US
Practice Address - Phone:336-835-3136
Practice Address - Fax:336-835-6038
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004056363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health