NPI Profile for IVAN S MARDEN in REDDICK, FL.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Administrator |
163WA2000X |
| NPI # | 1861720948 |
|
| Status | Active | |
| Credentials | RN (Registered Nurse) | |
| Entity | Individual | |
| Enumeration date | 11/30/2009 | |
| Last updated | 11/30/2009 - About 17 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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IVAN S MARDEN
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