Individual
CAROLYN RUTH MARCUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5865 RIDEWAY CENTER PARKWAY, MEMPHIS, TN 38120-3812
(337) 991-9276
(337) 943-0846
Mailing address
1509 DULLES DR, LAFAYETTE, LA 70506-3718
(337) 991-9276
(337) 943-0846
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
141621
TN
363L00000X
Nurse Practitioner
13353
TN
363L00000X
Nurse Practitioner
A810297
MS
363LF0000X
Family Nurse Practitioner
Primary
APN13353
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00927745
—
MS
05
—
168400758
—
AR
01
—
1801067251
AR BCBS
AR
05
—
3341699
—
TN
01
—
4182890
TN BCBS
TN
Enumeration date
03/13/2008
Last updated
02/10/2022
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