Provider Demographics
NPI:1063448108
Name:EARLE, MARILYN MCSHERRY (MSN RN CS)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:MCSHERRY
Last Name:EARLE
Suffix:
Gender:F
Credentials:MSN RN CS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:10 OLD COUNTRY ROSES
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29909
Mailing Address - Country:US
Mailing Address - Phone:843-548-0311
Mailing Address - Fax:843-548-0311
Practice Address - Street 1:10 OLD COUNTRY ROSES
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29909
Practice Address - Country:US
Practice Address - Phone:843-548-0311
Practice Address - Fax:843-548-0311
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC011044301364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult