Provider Demographics
NPI:1447392725
Name:GRONLEY, MARIE NANETTA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIE
Middle Name:NANETTA
Last Name:GRONLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:15849 N 71ST ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-2179
Mailing Address - Country:US
Mailing Address - Phone:480-922-8490
Mailing Address - Fax:480-281-1529
Practice Address - Street 1:15849 N 71ST ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-2179
Practice Address - Country:US
Practice Address - Phone:480-922-8490
Practice Address - Fax:480-281-1529
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ253242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry