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General NPI Number Information
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NPI Number | 1013301118
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Entity Type | Individual
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Provider Name | MARKITA GARRISON
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Gender | Female
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Dates
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Enumeration Date | 03/26/2015
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Last Update Date | 03/26/2015
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Provider Practice Location Address
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Address Line | 400 OAKDALE RD
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-3637
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Country | US
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Telephone | 252-360-9806
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Fax | 252-210-2967
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Provider Business Mailing Address
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Address Line | PO BOX 1311
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City | ROCKY MOUNT
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State | NC
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Zip | 27802-1311
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Country | US
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Telephone | 252-360-9806
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Fax | 252-210-2967
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State | NC
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