Provider Demographics
NPI:1508362617
Name:LAYNE, MARLA (ARNP)
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:
Last Name:LAYNE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11737 BIG BONE CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:KY
Mailing Address - Zip Code:41091-9735
Mailing Address - Country:US
Mailing Address - Phone:513-720-2748
Mailing Address - Fax:
Practice Address - Street 1:11737 BIG BONE CHURCH RD
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:KY
Practice Address - Zip Code:41091-9735
Practice Address - Country:US
Practice Address - Phone:513-720-2748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-05
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3009905363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily