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NPI Code Detail

MEDICARE: MARLA BYRUM NP

MEDICARE: MARLA BYRUM NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner1-135814AL

General Provider Information

NPI Number : 1003392002
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARLA BYRUM NP
Provider Business Mailing Address
First Line : 1509 DULLES DR
Second Line :
City : LAFAYETTE
State : LA
Zip : 70506-3718
Country : US
Telephone Number : 337-991-9276
Fax Number : 337-943-0846
Provider Business Practice Location Address
First Line : 412 W CLOVERDALE RD
Second Line :
City : SCOTTSBORO
State : AL
Zip : 35768-4264
Country : US
Telephone Number : 337-991-9276
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2018
Last Update Date : 07/13/2018

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Directions to “ MARLA BYRUM NP” Practice Location

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