Provider Demographics
NPI:1295374056
Name:CURTIS, MARILYN KAY
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:KAY
Last Name:CURTIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14399 CLEVELAND RD SW
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-7801
Mailing Address - Country:US
Mailing Address - Phone:614-515-9011
Mailing Address - Fax:
Practice Address - Street 1:14399 CLEVELAND RD SW
Practice Address - Street 2:
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062-7801
Practice Address - Country:US
Practice Address - Phone:614-515-9011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-27
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide