Provider Demographics
NPI:1811274855
Name:HEADLEE, MARSHA G (MEDICAL TECHNOLOGIST)
Entity type:Individual
Prefix:
First Name:MARSHA
Middle Name:G
Last Name:HEADLEE
Suffix:
Gender:F
Credentials:MEDICAL TECHNOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 ABRAHAM FLEXNER WAY
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-3849
Mailing Address - Country:US
Mailing Address - Phone:502-561-2180
Mailing Address - Fax:
Practice Address - Street 1:201 ABRAHAM FLEXNER WAY
Practice Address - Street 2:SUITE 1200
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3849
Practice Address - Country:US
Practice Address - Phone:502-561-2180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study