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NPI Code Detail

MEDICARE: MARION DOUGLAS RN

MEDICARE: MARION DOUGLAS RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse0001143295VA

General Provider Information

NPI Number : 1164387668
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARION DOUGLAS RN
Provider Business Mailing Address
First Line : 304 LEGACY OAKS CIR
Second Line :
City : LYNCHBURG
State : VA
Zip : 24501-3749
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 142 S MAIN ST
Second Line :
City : DANVILLE
State : VA
Zip : 24541-2922
Country : US
Telephone Number : 844-467-6824
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2025
Last Update Date : 12/17/2025

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