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General NPI Number Information
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NPI Number | 1326937137
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Entity Type | Individual
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Provider Name | MARLENE KING CHISHOLM RN
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Gender | Female
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 16 OAK GROVE ST UNIT 8
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City | MOUNT HOLLY
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State | NC
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Zip | 28120-1655
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Country | US
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Telephone | 980-437-4109
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Fax | 888-830-7437
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Provider Business Mailing Address
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Address Line | 905 CASSIDY DR
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City | GASTONIA
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State | NC
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Zip | 28054-4306
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Country | US
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Telephone | 704-460-5292
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 380369
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 380369
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License Number State | NC
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