Michael Bradley Marks, FNP
Nurse Practitioner in Jacksonville, NC. Individual provider (NPI-1).
NPI number1922077940
StatusActive
Last updated in NPPESMar 20, 2019
Details
- NPI
- 1922077940
- Entity type
- Individual (NPI-1)
- Name
- Michael Bradley Marks
- Credential
- FNP
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 14, 2006
- Last updated
- Mar 20, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 3012624 | KY | Yes |
| 363LF0000X | Nurse Practitioner, Family | 201201 | NC | |
| 363L00000X | Nurse Practitioner | 201201 | NC |
Practice location
3280a Henderson DrJacksonville, NC 28546-5250
Phone 910-937-7200 · Fax 910-937-7061
Mailing address
Po Box 602373Charlotte, NC 28260-2373
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