Healthcare Provider Details

I. General information

NPI: 1730152620
Provider Name (Legal Business Name): MARIANNE MCIVER CNS, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 E RALEIGH ST
SILER CITY NC
27344-3416
US

IV. Provider business mailing address

234 E RALEIGH ST
SILER CITY NC
27344-3416
US

V. Phone/Fax

Practice location:
  • Phone: 919-663-1137
  • Fax:
Mailing address:
  • Phone: 919-663-1137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberAPN 2342
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number101752
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: