Individual
MRS. MARLA ANNE SHAMPINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
25 WILSON ST, GOUVERNEUR, NY 13642-1328
(315) 287-4300
Mailing address
25 WILSON ST, GOUVERNEUR, NY 13642-1328
(315) 287-4300
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
318244-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013-82127
—
NY
Enumeration date
06/07/2012
Last updated
06/07/2012
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