Provider Demographics
NPI:1891016309
Name:ANDERSON, MARJORIE S (MS,RN, PMHCNS-BC)
Entity Type:Individual
Prefix:MS
First Name:MARJORIE
Middle Name:S
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MS,RN, PMHCNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 W 10TH AVE
Mailing Address - Street 2:STARLING LOVING M 200
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43210-1280
Mailing Address - Country:US
Mailing Address - Phone:614-293-3237
Mailing Address - Fax:614-293-6037
Practice Address - Street 1:320 W 10TH AVE
Practice Address - Street 2:STARLING LOVING M 200
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1280
Practice Address - Country:US
Practice Address - Phone:614-293-3237
Practice Address - Fax:614-293-6037
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH124577163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult