Provider Demographics
NPI:1972296424
Name:MARLEY, ANGELA IDA-LOUISE (RN BSN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:IDA-LOUISE
Last Name:MARLEY
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 WINES DR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-2541
Mailing Address - Country:US
Mailing Address - Phone:734-968-1916
Mailing Address - Fax:
Practice Address - Street 1:1221 WINES DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-2541
Practice Address - Country:US
Practice Address - Phone:734-968-1916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704279295163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine