Provider Demographics
NPI:1659559797
Name:MARKS, CAROLE LYNNETTE (DNP, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:CAROLE
Middle Name:LYNNETTE
Last Name:MARKS
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3381 NW 46TH AVE
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33319-5749
Mailing Address - Country:US
Mailing Address - Phone:954-662-1339
Mailing Address - Fax:
Practice Address - Street 1:3381 NW 46TH AVE
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33319-5749
Practice Address - Country:US
Practice Address - Phone:954-662-1339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-31
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH10433363LF0000X
FL1449912363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily