MEDICARE: MARY ELIZABETH MARBLE NP-C

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	363LF0000X	Family Nurse Practitioner	6880193-4405	UT
2	363LF0000X	Family Nurse Practitioner	95016616	CA

General Provider Information

NPI Number	:	1346518867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY ELIZABETH MARBLE NP-C

Provider Business Mailing Address
First Line	:	1441 CONSTITUTION BLVD
Second Line	:
City	:	SALINAS
State	:	CA
Zip	:	93906-3100
Country	:	US
Telephone Number	:	831-755-4111
Fax Number	:

Provider Business Practice Location Address
First Line	:	1441 CONSTITUTION BLVD
Second Line	:
City	:	SALINAS
State	:	CA
Zip	:	93906-3100
Country	:	US
Telephone Number	:	831-755-4111
Fax Number	:

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

Provider Enumeration Date	:	12/12/2011
Last Update Date	:	01/16/2026

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