Individual
MARY LYNN MARKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
520 MARY ST STE 340, EVANSVILLE, IN 47710
(812) 450-3201
(812) 450-3395
Mailing address
PO BOX 1510, EVANSVILLE, IN 47706-1510
(812) 450-3201
(812) 450-3395
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71002384A
IN
363LA2100X
Acute Care Nurse Practitioner
71002384A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200828260
—
IN
Enumeration date
05/13/2006
Last updated
05/14/2018
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