Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 600073 | NC |
NPI | 1003949843 |
---|---|
Provider Name | Deanna Gay Markham |
First Address | Asheboro, NC 27205-7186 |
Second Address | Asheboro, NC 27203-6257 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
600073 | PRACTICE APPROVAL NUMBER- (01) | NC |
MM0286509 | DEA NUMBER (01) | NC |