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NPI Code Detail

MEDICARE: MARLENE KING CHISHOLM RN

MEDICARE: MARLENE KING CHISHOLM 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 Nurse380369NC
2163WH0200XHome Health Registered Nurse380369NC
3251E00000XHome Health Agency
4291U00000XClinical Medical LaboratoryNC

General Provider Information

NPI Number : 1326937137
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARLENE KING CHISHOLM RN
Provider Business Mailing Address
First Line : 905 CASSIDY DR
Second Line :
City : GASTONIA
State : NC
Zip : 28054-4306
Country : US
Telephone Number : 704-460-5292
Fax Number :
Provider Business Practice Location Address
First Line : 16 OAK GROVE ST UNIT 8
Second Line :
City : MOUNT HOLLY
State : NC
Zip : 28120-1655
Country : US
Telephone Number : 980-437-4109
Fax Number : 888-830-7437
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2025
Last Update Date : 01/14/2026

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Directions to “ MARLENE KING CHISHOLM RN” Practice Location

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