Provider Demographics
NPI:1043587173
Name:BANGERT, MARION ELIZABETH (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARION
Middle Name:ELIZABETH
Last Name:BANGERT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 VASSAR RD
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-5451
Mailing Address - Country:US
Mailing Address - Phone:845-463-7860
Mailing Address - Fax:845-463-7859
Practice Address - Street 1:174 VASSAR RD
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-5451
Practice Address - Country:US
Practice Address - Phone:845-463-7860
Practice Address - Fax:845-463-7859
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY314237-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool