Individual
MARVIS M. IVEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
843 ARBOR CT, STONE MOUNTAIN, GA 30088-2371
(404) 296-4026
Mailing address
843 ARBOR CT, STONE MOUNTAIN, GA 30088-2371
(404) 296-4026
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN054334
GA
163WG0000X
General Practice Registered Nurse
5435721
NY
310400000X
Assisted Living Facility
RN054334
GA
311ZA0620X
Adult Care Home Facility
RN054334
GA
Other
Enumeration date
11/18/2007
Last updated
11/18/2007
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