MEDICARE: CAROL LOUISE MARSDEN F.N.P., A.P.R.N.

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	RN192181	GA

General Provider Information

NPI Number	:	1144567025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL LOUISE MARSDEN F.N.P., A.P.R.N.

Provider Business Mailing Address
First Line	:	210 SPRINGBROOK LN
Second Line	:
City	:	WINTERVILLE
State	:	GA
Zip	:	30683-1619
Country	:	US
Telephone Number	:	706-372-5136
Fax Number	:

Provider Business Practice Location Address
First Line	:	1905 BARNETT SHOALS RD
Second Line	:
City	:	ATHENS
State	:	GA
Zip	:	30605-3625
Country	:	US
Telephone Number	:	706-389-6828
Fax Number	:

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

Provider Enumeration Date	:	01/11/2013
Last Update Date	:	01/11/2013

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