Individual
MRS. CHRISTY EARLEAN MARVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
1111 E MAIN ST, WEISER, ID 83672
(208) 861-1074
Mailing address
1111 E MAIN ST, WEISER, ID 83672
(208) 861-1074
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
00016921203
ID
Other
Enumeration date
08/21/2008
Last updated
08/21/2008
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