Individual
MRS. KALI YVONNE ELENE MARCUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
18243 MARCUM LN, LAUREL, IN 47024
(513) 504-2517
Mailing address
18243 MARCUM LN, LAUREL, IN 47024-8304
(513) 504-2517
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
27063400A
IN
164W00000X
Licensed Practical Nurse
Primary
PN 129267
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0180198824
DRIVERS LICENSURE
IN
01
—
27063400A
INDIANA NURSING LICENSURE
—
01
—
PN 129267
OHIO NURSING LICENSURE
OH
Enumeration date
05/05/2011
Last updated
05/05/2011
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