Provider Demographics
NPI:1922863539
Name:CORLEY, MARISA ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARISA
Middle Name:ANN
Last Name:CORLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CMR 480 BOX 1813
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09128-0019
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:U.S. ARMY HEALTH CLINIC STUTTGART
Practice Address - Street 2:UNIT 30401 PATCH BARRACKS GERMANY
Practice Address - City:STUTTGART
Practice Address - State:BADEN-WURTEMBURG
Practice Address - Zip Code:09107
Practice Address - Country:DE
Practice Address - Phone:314-430-7990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA641409163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse