Provider Demographics
NPI:1831341502
Name:CORLEY, MARSHA KAYE (CNA)
Entity type:Individual
Prefix:MRS
First Name:MARSHA
Middle Name:KAYE
Last Name:CORLEY
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43613 REVERE DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48111-1672
Mailing Address - Country:US
Mailing Address - Phone:313-580-8378
Mailing Address - Fax:
Practice Address - Street 1:43613 REVERE DR
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48111-1672
Practice Address - Country:US
Practice Address - Phone:313-580-8378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-14
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI230014051650308376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide