Provider Demographics
NPI:1902102031
Name:JONES, MARLA L (RN)
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:L
Last Name:JONES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 70667
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29572-0030
Mailing Address - Country:US
Mailing Address - Phone:843-497-7771
Mailing Address - Fax:843-497-7775
Practice Address - Street 1:1021 CIPRIANA DR
Practice Address - Street 2:SUITE 230
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572-4621
Practice Address - Country:US
Practice Address - Phone:843-497-7771
Practice Address - Fax:843-497-7775
Is Sole Proprietor?:No
Enumeration Date:2011-02-08
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC58272163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse