Provider Demographics
NPI:1922360643
Name:FUSON, MARLENE ANGEL (ND)
Entity Type:Individual
Prefix:DR
First Name:MARLENE
Middle Name:ANGEL
Last Name:FUSON
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1548 HIGHTOP RD
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-9560
Mailing Address - Country:US
Mailing Address - Phone:606-304-5008
Mailing Address - Fax:
Practice Address - Street 1:4702 5TH STREET ROAD
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701
Practice Address - Country:US
Practice Address - Phone:606-261-6278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-08
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath