Individual
MRS. MARILYN ELIZABETH NIBLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Contact information
Practice address
1231 FM 3405, GEORGETOWN, TX 78633-4344
(512) 930-1628
Mailing address
1231 FM 3405, GEORGETOWN, TX 78633-4344
(512) 930-1628
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
506272
TX
363LN0005X
Critical Care Neonatal Nurse Practitioner
506272
TX
Other
Enumeration date
04/15/2006
Last updated
07/11/2007
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