Provider Demographics
NPI:1811195332
Name:MARKS, MARY ANN G (ARNP MS)
Entity Type:Individual
Prefix:MS
First Name:MARY ANN
Middle Name:G
Last Name:MARKS
Suffix:
Gender:F
Credentials:ARNP MS
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 2394
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32961-2394
Mailing Address - Country:US
Mailing Address - Phone:305-849-2586
Mailing Address - Fax:
Practice Address - Street 1:2448 57TH CIR
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32966-4643
Practice Address - Country:US
Practice Address - Phone:305-849-2586
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL452052363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner