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Individual

JOHN A MARBLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
100 MEDICAL CENTER DRIVE, SLIDELL, LA 70461-5520
(985) 641-7670
Mailing address
100 MEDICAL CENTER DRIVE, SLIDELL, LA 70461-5520
(985) 649-7070

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
04648
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04648
ADVANCED PRACTICE
LA
05
06122221
MS
01
098770
RN LICENSE
LA
05
1320749
LA
Enumeration date
06/12/2006
Last updated
03/26/2020
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