Healthcare Provider Details

I. General information

NPI: 1780716670
Provider Name (Legal Business Name): MARY CATHERINE POLANSKI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 11/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 FRANKLIN PLAZA DR
FRANKLIN NC
28734-3249
US

IV. Provider business mailing address

PO BOX 1209
FRANKLIN NC
28744-0569
US

V. Phone/Fax

Practice location:
  • Phone: 828-369-4427
  • Fax: 828-369-4464
Mailing address:
  • Phone: 828-213-1500
  • Fax: 828-651-6570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN 603
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5004566
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number234982
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: