Individual
MARCIA K CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
5901 MONCLOVA RD, MAUMEE, OH 43537-1855
(419) 897-8370
Mailing address
570 OAK KNOLL DR, PERRYSBURG, OH 43551-2904
(419) 872-0540
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
COA.01957-NA
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0768665
—
OH
Enumeration date
02/10/2006
Last updated
02/26/2008
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