Provider Demographics
NPI:1346644572
Name:CAPES, MARLA RUTH (APRN)
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:RUTH
Last Name:CAPES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MARLA
Other - Middle Name:RUTH
Other - Last Name:JACOBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 746638
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6638
Mailing Address - Country:US
Mailing Address - Phone:904-202-1032
Mailing Address - Fax:904-376-4107
Practice Address - Street 1:230 VILLAGE COMMONS DRIVE
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092-8805
Practice Address - Country:US
Practice Address - Phone:904-940-1441
Practice Address - Fax:904-390-7463
Is Sole Proprietor?:No
Enumeration Date:2014-10-17
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9437834363LF0000X
TNAPN19246363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily