Provider Demographics
NPI:1952030835
Name:FOLK, MARILOU GALVAN (APRN)
Entity Type:Individual
Prefix:
First Name:MARILOU
Middle Name:GALVAN
Last Name:FOLK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:579 S INDIANA AVE STE A
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-3751
Mailing Address - Country:US
Mailing Address - Phone:941-460-1341
Mailing Address - Fax:
Practice Address - Street 1:579 S INDIANA AVE STE A
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223-3751
Practice Address - Country:US
Practice Address - Phone:941-460-1341
Practice Address - Fax:941-460-1346
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11019976363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily