Individual
MRS. MARY JONES SOMERVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
303 W FRANKLIN ST, WARRENTON, NC 27589-1937
(252) 257-4568
(252) 257-2388
Mailing address
686 AXTELL RIDGEWAY RD, NORLINA, NC 27563-9250
(252) 456-4239
(252) 456-3718
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
715493
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7801382
—
NC
Enumeration date
02/19/2007
Last updated
07/09/2007
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