Provider Demographics
NPI:1437789310
Name:ATKINSON, MARIANNE BETH (FNP)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:BETH
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18909 DOONEY CT
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-7518
Mailing Address - Country:US
Mailing Address - Phone:765-615-2390
Mailing Address - Fax:
Practice Address - Street 1:2541 NORTHSHORE BLVD
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46011-9600
Practice Address - Country:US
Practice Address - Phone:765-641-0022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-20
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INF01200623363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily