Provider Demographics
NPI:1396737375
Name:VENABLE, CAROLE MCDUFFIE (RNC FNP)
Entity type:Individual
Prefix:
First Name:CAROLE
Middle Name:MCDUFFIE
Last Name:VENABLE
Suffix:
Gender:F
Credentials:RNC FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1446
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28380-1446
Mailing Address - Country:US
Mailing Address - Phone:910-895-6650
Mailing Address - Fax:910-895-6682
Practice Address - Street 1:125 BILTMORE DR
Practice Address - Street 2:SUITE #2
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-4994
Practice Address - Country:US
Practice Address - Phone:910-895-6650
Practice Address - Fax:910-895-6682
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC39673363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2599191COtherMEDICARE
NC2599191COtherMEDICARE