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General NPI Number Information
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NPI Number | 1467758730
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Entity Type | Individual
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Provider Name | IRMA MARRIOTT NP
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Gender | Female
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Dates
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Enumeration Date | 02/04/2011
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Last Update Date | 09/01/2022
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Provider Practice Location Address
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Address Line | 2502 E. RICHARDSON
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City | EDINBURG
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State | TX
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Zip | 78539-8541
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Country | US
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Telephone | 956-380-4477
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Fax | 956-380-4478
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Provider Business Mailing Address
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Address Line | 17198 ST LUKES WAY STE 440
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City | THE WOODLANDS
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State | TX
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Zip | 77384-8015
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SW0102X
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Taxonomy Name | Women's Health Clinical Nurse Specialist
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License Number | 625642
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 625642
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License Number State | TX
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