Healthcare Provider Details

I. General information

NPI: 1548197775
Provider Name (Legal Business Name): EDEN MARBLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 UNIVERSITY HOSPITAL DR
MOBILE AL
36617-2300
US

IV. Provider business mailing address

1429 OAK VALE CT
MOBILE AL
36609-2206
US

V. Phone/Fax

Practice location:
  • Phone: 251-470-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-181176
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: