Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | 26743 | TN |
Y | 363LG0600X | Nurse Practitioner - Gerontology | 26743 | TN |
NPI | 1003067992 |
---|---|
Provider Name | Mrs. Marjorie Menardy Magloire |
First Address | Chattanooga, TN 37412-2720 |
Second Address | Chattanooga, TN 37412-2720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2008 |
Last Update Date | 16/03/2020 |