Healthcare Provider Details

I. General information

NPI: 1134463177
Provider Name (Legal Business Name): SHEILA ANNE MAARAN R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2012
Last Update Date: 11/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 HENDERSON DR
JACKSONVILLE NC
28540-5601
US

IV. Provider business mailing address

PO BOX 752
JACKSONVILLE NC
28541-0752
US

V. Phone/Fax

Practice location:
  • Phone: 910-353-5555
  • Fax: 910-353-4833
Mailing address:
  • Phone: 910-353-5555
  • Fax: 910-353-4833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number252297
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number252297
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number252297
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number252297
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: