Provider Demographics
NPI:1497174213
Name:MARKLE, CARISSA LORRAINE
Entity Type:Individual
Prefix:
First Name:CARISSA
Middle Name:LORRAINE
Last Name:MARKLE
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 1:327 RIVERVIEW DR
Mailing Address - Street 2:UNIT 5728
Mailing Address - City:ELLIJAY
Mailing Address - State:GA
Mailing Address - Zip Code:30540-5486
Mailing Address - Country:US
Mailing Address - Phone:678-793-3536
Mailing Address - Fax:
Practice Address - Street 1:327 RIVERVIEW DR
Practice Address - Street 2:UNIT 5728
Practice Address - City:ELLIJAY
Practice Address - State:GA
Practice Address - Zip Code:30540-5486
Practice Address - Country:US
Practice Address - Phone:678-793-3536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula