Provider Demographics
NPI:1093930877
Name:ARTIS, MARION E (LPN)
Entity Type:Individual
Prefix:
First Name:MARION
Middle Name:E
Last Name:ARTIS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:MARION
Other - Middle Name:E
Other - Last Name:YORK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5547
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23605-0547
Mailing Address - Country:US
Mailing Address - Phone:757-592-9050
Mailing Address - Fax:
Practice Address - Street 1:10608 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601-3104
Practice Address - Country:US
Practice Address - Phone:757-592-9050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNP000547164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse