Provider Demographics
NPI:1144567025
Name:MARSDEN, CAROL LOUISE (FNP, APRN)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:LOUISE
Last Name:MARSDEN
Suffix:
Gender:F
Credentials:FNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 SPRINGBROOK LN
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30683-1619
Mailing Address - Country:US
Mailing Address - Phone:706-372-5136
Mailing Address - Fax:
Practice Address - Street 1:1905 BARNETT SHOALS RD
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30605-3625
Practice Address - Country:US
Practice Address - Phone:706-389-6828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN192181363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily