Provider Demographics
NPI:1902066467
Name:DEWIER, MARIANNE (APRN CPNP)
Entity Type:Individual
Prefix:MS
First Name:MARIANNE
Middle Name:
Last Name:DEWIER
Suffix:
Gender:F
Credentials:APRN CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 RED MILE PL
Mailing Address - Street 2:UK FAMILY CARE CENTER CLINIC
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-1172
Mailing Address - Country:US
Mailing Address - Phone:859-218-2273
Mailing Address - Fax:
Practice Address - Street 1:1135 HARRY SYKES WAY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-1383
Practice Address - Country:US
Practice Address - Phone:859-218-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3009679363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics