Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 5014014 | NC |
NPI | 1306437074 |
---|---|
Provider Name | Cherilyn A Marrs |
First Address | Jonas Ridge, NC 28641-0111 |
Second Address | Reidsville, NC 27320-5340 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2021 |
Last Update Date | 16/11/2021 |