MEDICARE: MARILYN ELAINE YERGLER RN

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
1	163WC1600X	Continuing Education/Staff Development Registered Nurse	R11649	AR

General Provider Information

NPI Number	:	1194911230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARILYN ELAINE YERGLER RN

Provider Business Mailing Address
First Line	:	4919 FURMAN ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-1707
Country	:	US
Telephone Number	:	870-219-5421
Fax Number	:

Provider Business Practice Location Address
First Line	:	4919 FURMAN ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-1707
Country	:	US
Telephone Number	:	870-219-5421
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2007
Last Update Date	:	09/21/2007

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