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General NPI Number Information
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NPI Number | 1235609629
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Entity Type | Individual
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Provider Name | MARION STOLTZFUS BRADEN ALEXANDER FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/28/2018
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 600 CHATHAM MEDICAL PARK
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City | ELKIN
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State | NC
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Zip | 28621-2482
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Country | US
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Telephone | 336-835-4819
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Fax |
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Provider Business Mailing Address
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Address Line | 360 PARKWOOD MEDICAL PARK
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City | ELKIN
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State | NC
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Zip | 28621-2444
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Country | US
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Telephone |
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5011272
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License Number State | NC
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