Provider Demographics
NPI:1689692394
Name:SOBECK, MARILYN S (RN,MS,FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:S
Last Name:SOBECK
Suffix:
Gender:F
Credentials:RN,MS,FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3840 INVERNESS DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77707-5454
Mailing Address - Country:US
Mailing Address - Phone:409-840-9903
Mailing Address - Fax:
Practice Address - Street 1:3840 INVERNESS DR
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77707-5454
Practice Address - Country:US
Practice Address - Phone:409-840-9903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX614680363LF0000X
MI4704271101363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily