Provider Demographics
NPI:1902970825
Name:KOEBCKE, MARSHA LYNN (RN FNP)
Entity Type:Individual
Prefix:MS
First Name:MARSHA
Middle Name:LYNN
Last Name:KOEBCKE
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Gender:F
Credentials:RN FNP
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Mailing Address - Street 1:11420 BEE CAVES RD
Mailing Address - Street 2:SUITE A-150
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78738-5528
Mailing Address - Country:US
Mailing Address - Phone:512-263-9072
Mailing Address - Fax:512-402-9057
Practice Address - Street 1:11420 BEE CAVES RD
Practice Address - Street 2:SUITE A-150
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78738-5528
Practice Address - Country:US
Practice Address - Phone:512-263-9072
Practice Address - Fax:512-402-9057
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG01364363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily