Individual
MRS. MARJORIE LAUREL HEADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4951 DIANTHA WAY, BROOKSVILLE, FL 34604-8283
(414) 803-4986
Mailing address
2458 W LLOYD ST, MILWAUKEE, WI 53205-1048
(414) 803-4986
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
187915-30
WI
163W00000X
Registered Nurse
Primary
RN9668886
FL
164W00000X
Licensed Practical Nurse
Primary
301935031
WI
Other
Enumeration date
03/16/2009
Last updated
01/27/2026
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