Individual
CAROLYN S MARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2000
Mailing address
PO BOX 504274, SAINT LOUIS, MO 63150-4274
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2002007745
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
427268107
—
MO
Enumeration date
08/14/2006
Last updated
03/31/2015
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