MRS. JACQUELINE MARKS (NPI# 1942634175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1942634175 |
Entity Type | Individual |
Full Name | MRS. JACQUELINE MARKS |
Credential | NP |
Practice Address |
450 Northside Cherokee Blvd Canton GA 30115-8015 |
Mailing Address |
7703 Floyd Curl Dr Mc7977 San Antonio TX 78229-3901 |
Practice Telephone | 7702241000 |
Practice Fax Number | 7702242451 |
Mailing Telephone | 2103584000 |
Enumeration Date | 2013-08-23 |
Last Update Date | 2020-04-29 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
RN163623 | GA | Physician Assistants & Advanced Practice Nursing Providers |
N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
840805 | TX | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | CSHCN | 327389803 | 01 |
TX | 327389802 | 05 |
Street Address |
450 NORTHSIDE CHEROKEE BLVD |
City | CANTON |
State | GA |
Zip Code | 30115-8015 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295732600 | Paul J Hyler | Internal Medicine | 450 Northside Cherokee Blvd, Canton, GA 30115-8015 | 2005-06-30 |
1790390706 | Bradley Louis Mccoul | Pharmacist | 450 Northside Cherokee Blvd, Canton, GA 30115-8015 | 2020-09-15 |
1164035747 | Candice Caroline Bramlett | Pharmacist | 450 Northside Cherokee Blvd, Canton, GA 30115-8015 | 2020-08-25 |
1336751494 | Kalum Leiba | Anesthesiologist Assistant | 450 Northside Cherokee Blvd, Canton, GA 30115-8015 | 2020-08-20 |
1093339533 | Tara Talbott Oberman | Pharmacist | 450 Northside Cherokee Blvd, Canton, GA 30115-8015 | 2020-06-01 |
1568085157 | Ross W Devantier | Specialist/Technologist, Other | 450 Northside Cherokee Blvd, Canton, GA 30115-8015 | 2020-05-19 |
1427679034 | Joseph Liverman | Specialist/Technologist, Other | 450 Northside Cherokee Blvd, Canton, GA 30115-8015 | 2020-05-05 |
1518595503 | Erica D Burns | Pharmacist | 450 Northside Cherokee Blvd, Canton, GA 30115-8015 | 2020-03-27 |
1093346066 | Emily Beecher | Pharmacist | 450 Northside Cherokee Blvd, Canton, GA 30115-8015 | 2020-01-29 |
1497393268 | Stephanie Knight Ellis | Pharmacist | 450 Northside Cherokee Blvd, Canton, GA 30115-8015 | 2019-12-12 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497364806 | Amanda Arbogast | Speech-Language Pathologist | 610 Royal Crest Court, Canton, GA 30115 | 2020-07-31 |
1033754163 | Kelly Marie Shirley | Nurse Practitioner | 450 Northside Cherokee Blvd., Radiology Dept., Canton, GA 30115 | 2019-11-13 |
1700394319 | Jennifer Lynn Davenport | Nurse Practitioner | 684 Sixes Rd Ste 125, Holly Springs, GA 30115 | 2018-01-17 |
1851717961 | Wal-mart Stores East, Lp | Technician/Technologist | 2200 Holly Springs Pkey, Holly Springs, GA 30115 | 2014-03-13 |
1194148502 | Julia Bedingfield Reid | Pharmacist | 450 Northside Cherokee Blvd Ste T20, Canton, GA 30115 | 2014-01-22 |
1447597992 | America's Best Contacts & Eyeglasses | Technician/Technologist | 2030 Cumming Highway, Suite 106, Canton, GA 30115 | 2013-01-03 |
1679821193 | Jill M Decorso | Speech-Language Pathologist | 4280 Hickory Flat Hwy, Ste 108, Canton, GA 30115 | 2012-08-15 |
1306113378 | Sidney Boyd Collier IIi | Pharmacist | 6111 Hickory Flat Highway, Canton, GA 30115 | 2011-11-18 |
1174804702 | Rayllensons Itacy | Physician Assistant | 2020 Cumming Highway, Suite 102, Canton, GA 30115 | 2011-09-09 |
1245534346 | Kim M. Mcmillan | Counselor | 154 Lakeside Drive, Canton, GA 30115 | 2011-01-04 |
Find all providers in zip 30115 |
Taxonomy Code | 363LP2300X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Primary Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578055349 | Laurie-ann Cadene Mitchell | Nurse Practitioner | 3271 Riverside Ct, Canton, MI 48188-2330 | 2018-06-06 |
1104328053 | Katelyn Marie Carey | Nurse Practitioner | 45300 Lothrop Rd, Canton, MI 48188-1080 | 2018-03-07 |
1760022834 | Sydney C Pritchett | Nurse Practitioner | 2600 Tuscarawas St W, Canton, OH 44708-4644 | 2020-01-07 |
1851879126 | Katina Grant | Nurse Practitioner | 122 E Academy St, Canton, MS 39046 | 2018-07-30 |
1235642778 | Joanne Marie Foith | Nurse Practitioner | 2600 Sixth St Sw, Canton, OH 44710-1702 | 2017-11-07 |
1346693504 | Kyle Mccarthy | Nurse Practitioner | 180 S Main St, Canton, IL 61520-2608 | 2016-07-22 |
1659765832 | Lucia V Ocanoviciu | Nurse Practitioner | 460 Northside Cherokee Blvd Ste 300, Canton, GA 30115-8019 | 2015-03-25 |
1104133321 | Laura R. Pierce | Nurse Practitioner | 4650 Hills and Dales Rd Nw, Canton, OH 44708-6220 | 2010-09-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639784788 | Natasha Allen | Nurse Practitioner | 4177 Pelham Cir, Lithonia, GA 30038-6140 | 2020-09-14 |
1336753920 | Henny P Brown | Nurse Practitioner | 3430 Ridgeland Pl, Alpharetta, GA 30004-8483 | 2020-09-01 |
1487267415 | Alethea Hope Tucker | Nurse Practitioner | 3685 Braselton Hwy Ste 100, Dacula, GA 30019-5920 | 2020-08-28 |
1952913808 | Carol Jo Wilbanks | Nurse Practitioner | 206 Crest Dr, Rock Spring, GA 30739-2041 | 2020-08-21 |
1164032017 | Myiesha Sellers Mcfarlin | Nurse Practitioner | 55 Sellers Ln, Baxley, GA 31513-2208 | 2020-08-05 |
1124645395 | Kisha Smalley | Nurse Practitioner | 117 Gambier Cv, Mcdonough, GA 30252-6273 | 2020-07-02 |
1346861127 | Finan Tedla | Nurse Practitioner | 2626 Peachtree Rd Nw Unit 1802, Atlanta, GA 30305-5633 | 2020-05-03 |
1841819547 | Millicent Charte Duncan | Nurse Practitioner | 138 Parkview Rd, Savannah, GA 31419-9672 | 2020-04-13 |
1891329660 | Tracey Lynn Murray | Nurse Practitioner | 980 Johnson Ferry Rd Ste 880, Sandy Springs, GA 30342-1609 | 2020-03-02 |
1841820917 | Vedic Family Practice and Wellness | Nurse Practitioner | 1240 Upper Hembree Rd Ste E, Roswell, GA 30076-0914 | 2020-01-17 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.