Provider Demographics
NPI:1528219854
Name:MCGLONE, MARCIA (APRN)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:
Last Name:MCGLONE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 233
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72845-0233
Mailing Address - Country:US
Mailing Address - Phone:479-518-8549
Mailing Address - Fax:479-479-3988
Practice Address - Street 1:1124 S ROGERS ST STE 3
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72830-7046
Practice Address - Country:US
Practice Address - Phone:479-309-9029
Practice Address - Fax:479-398-8346
Is Sole Proprietor?:No
Enumeration Date:2008-10-06
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARRN55367163WP0808X
ARA003928363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health