Provider Demographics
NPI:1811265960
Name:MARLEY, ELIZABETH A (CNM)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:MARLEY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6609 VIRGINIA PKWY
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5513
Mailing Address - Country:US
Mailing Address - Phone:972-542-8884
Mailing Address - Fax:214-544-9400
Practice Address - Street 1:6609 VIRGINIA PKWY
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-5513
Practice Address - Country:US
Practice Address - Phone:972-542-8884
Practice Address - Fax:214-544-9400
Is Sole Proprietor?:No
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX712184367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife