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Individual

MRS. MARILYN JANE HARROLD

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
C.R.N.A.

Contact information

Practice address
2314 ROSEWOOD AVE., NORTH NEWTON, KS 67117-0176
(316) 282-4847
Mailing address
2314 ROSEWOOD AVE., NORTH NEWTON, KS 67117-0176
(316) 282-4847

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
12-20734-012
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
144858
BLUE SHIELD
KS
Enumeration date
04/13/2006
Last updated
07/08/2007
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