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Individual

MARLEE BODLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
920 CHURCH ST N, CONCORD, NC 28025-2927
(704) 403-1412
Mailing address
896 STILLWATER DR, CHARLESTON, SC 29412-4922
(843) 425-4737

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
205465
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
276152
NC

Other

Enumeration date
07/08/2014
Last updated
03/27/2015
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