Provider Demographics
NPI:1588202048
Name:MARLOWE, SHAUNA LYNN (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:SHAUNA
Middle Name:LYNN
Last Name:MARLOWE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 GRANVILLE ST
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-8227
Mailing Address - Country:US
Mailing Address - Phone:740-403-9920
Mailing Address - Fax:
Practice Address - Street 1:4254 E MAIN ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-3031
Practice Address - Country:US
Practice Address - Phone:614-235-9944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-16
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH411105163W00000X
OH0035539363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered Nurse