Provider Demographics
NPI:1174710875
Name:MARSHALLECK, MAJORIE THERESA (CERTIFIED NURSES AS)
Entity type:Individual
Prefix:MS
First Name:MAJORIE
Middle Name:THERESA
Last Name:MARSHALLECK
Suffix:
Gender:F
Credentials:CERTIFIED NURSES AS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 SAMANTHA COURT
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112
Mailing Address - Country:US
Mailing Address - Phone:717-343-8294
Mailing Address - Fax:
Practice Address - Street 1:7 SAMANTHA COURT
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112
Practice Address - Country:US
Practice Address - Phone:717-343-8294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA9134133376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide