Provider Demographics
NPI:1558783043
Name:MARLIN, BETTY ELIZABETH (BSN, MSN, CNS, FNE)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:ELIZABETH
Last Name:MARLIN
Suffix:
Gender:F
Credentials:BSN, MSN, CNS, FNE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 BEATTIES FORD RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-5334
Mailing Address - Country:US
Mailing Address - Phone:704-347-1172
Mailing Address - Fax:704-347-1172
Practice Address - Street 1:508 BEATTIES FORD RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-5334
Practice Address - Country:US
Practice Address - Phone:704-347-1172
Practice Address - Fax:704-347-1172
Is Sole Proprietor?:No
Enumeration Date:2014-01-17
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC039143163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse