Provider Demographics
NPI:1952923245
Name:LENNOX, MARIE DOROTHY (APRN)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:DOROTHY
Last Name:LENNOX
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:DOROTHY
Other - Last Name:HANKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:3469 W BOYNTON BEACH BLVD STE 18
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-4639
Mailing Address - Country:US
Mailing Address - Phone:561-576-9404
Mailing Address - Fax:954-493-3483
Practice Address - Street 1:3469 W BOYNTON BEACH BLVD STE 18
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-4639
Practice Address - Country:US
Practice Address - Phone:954-576-9404
Practice Address - Fax:954-493-3483
Is Sole Proprietor?:No
Enumeration Date:2020-05-11
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11006576363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106663400Medicaid