Provider Demographics
NPI:1750354650
Name:MARLOT NURSING REGISTRY, INC.
Entity type:Organization
Organization Name:MARLOT NURSING REGISTRY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CRUMP
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:810-742-6471
Mailing Address - Street 1:3245 CARD DR
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48529-1809
Mailing Address - Country:US
Mailing Address - Phone:810-742-6471
Mailing Address - Fax:810-742-6472
Practice Address - Street 1:3245 CARD DR
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48529-1809
Practice Address - Country:US
Practice Address - Phone:810-742-6471
Practice Address - Fax:810-742-6472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI237261Medicare ID - Type UnspecifiedHOME HEALTH AGENCY