Provider Demographics
NPI:1669446043
Name:TOWLER, MARIANNE (CNM,ARNP)
Entity type:Individual
Prefix:
First Name:MARIANNE
Middle Name:
Last Name:TOWLER
Suffix:
Gender:F
Credentials:CNM,ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 S. GADSDEN ST.
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32310-6835
Mailing Address - Country:US
Mailing Address - Phone:850-576-4073
Mailing Address - Fax:850-576-2824
Practice Address - Street 1:1720 S GADSDEN ST
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-5506
Practice Address - Country:US
Practice Address - Phone:850-576-4073
Practice Address - Fax:850-576-2824
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1592962363LF0000X
FLARNP1592962363LX0001X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL033186400Medicaid
FLSG077996OtherVISTA (MCD)
FLY6949OtherBC/BS FLA
FL033186400Medicaid
FLS51602Medicare UPIN