Provider Demographics
NPI:1013340595
Name:MARKHAM, BOBBIE NICOLE (N/A)
Entity Type:Individual
Prefix:MS
First Name:BOBBIE
Middle Name:NICOLE
Last Name:MARKHAM
Suffix:
Gender:F
Credentials:N/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4402 JAMESTOWN DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78220-4508
Mailing Address - Country:US
Mailing Address - Phone:210-717-4713
Mailing Address - Fax:
Practice Address - Street 1:4402 JAMESTOWN DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78220-4508
Practice Address - Country:US
Practice Address - Phone:210-717-4713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-19
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion