1699001354 NPI number — MRS. SERANA SPALDING MARKHAM ANP

Table of content: MRS. SERANA SPALDING MARKHAM ANP (NPI 1699001354)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699001354 NPI number — MRS. SERANA SPALDING MARKHAM ANP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARKHAM
Provider First Name:
SERANA
Provider Middle Name:
SPALDING
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ANP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SPALDING
Provider Other First Name:
SERANA
Provider Other Middle Name:
LYZANNE MARIE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
ANP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1699001354
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/31/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5003 OLD CLINIC CB# 7550
Provider Second Line Business Mailing Address:
UNC HOSPITALS, UNC-SOM
Provider Business Mailing Address City Name:
CHAPEL HILL
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27599-7550
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-966-5945
Provider Business Mailing Address Fax Number:
336-251-1117

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6011 FARRINGTON ROAD, SUITE 101
Provider Second Line Business Practice Location Address:
UNC GERIATRIC CLINIC
Provider Business Practice Location Address City Name:
CHAPEL HILL
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27517
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-966-5945
Provider Business Practice Location Address Fax Number:
336-251-1117
Provider Enumeration Date:
10/30/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LG0600X , with the licence number:  5004540 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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