Individual
MS. MARJORIE ANN MAHLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CNP
Contact information
Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 298-4331
Mailing address
8280 YANKEE ST, CENTERVILLE, OH 45458-1806
(937) 436-4658
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
COA09531NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2794767
—
OH
Enumeration date
01/23/2007
Last updated
03/17/2018
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