Healthcare Provider Details

I. General information

NPI: 1821156902
Provider Name (Legal Business Name): LOUISE SCHRAMM MARLOW CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LUANN MARLOW CPNP, IBCLC

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 12/05/2020
Certification Date: 12/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4430 LASSEN CT
SUWANEE GA
30024-8745
US

IV. Provider business mailing address

4430 LASSEN CT
SUWANEE GA
30024-8745
US

V. Phone/Fax

Practice location:
  • Phone: 678-925-8494
  • Fax:
Mailing address:
  • Phone: 678-925-8494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN069888
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberLC000177
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: