Provider Demographics
NPI:1013163013
Name:ENGLISH-PICKETT, MARLA KAY (GNP)
Entity Type:Individual
Prefix:MS
First Name:MARLA
Middle Name:KAY
Last Name:ENGLISH-PICKETT
Suffix:
Gender:F
Credentials:GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16060 BROADLEAF
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-9607
Mailing Address - Country:US
Mailing Address - Phone:903-838-0031
Mailing Address - Fax:
Practice Address - Street 1:16060 BROADLEAF
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-9607
Practice Address - Country:US
Practice Address - Phone:903-838-0031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-11
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX565703363L00000X
TX55703364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology