Provider Demographics
NPI:1962683995
Name:MARKES, MARCY DAWN (APRN, FNP-BC, AE-C)
Entity Type:Individual
Prefix:
First Name:MARCY
Middle Name:DAWN
Last Name:MARKES
Suffix:
Gender:F
Credentials:APRN, FNP-BC, AE-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S KEENE ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-6603
Mailing Address - Country:US
Mailing Address - Phone:573-777-4700
Mailing Address - Fax:844-366-3221
Practice Address - Street 1:100 S KEENE ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-6603
Practice Address - Country:US
Practice Address - Phone:573-777-4700
Practice Address - Fax:844-366-3221
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-19
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO124665363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000080790Medicare PIN