Provider Demographics
NPI:1174934830
Name:DUCLAIR, MARIE VOLINE (ARNP)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:VOLINE
Last Name:DUCLAIR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16667 MURCOTT BLVD
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-1770
Mailing Address - Country:US
Mailing Address - Phone:561-512-8126
Mailing Address - Fax:
Practice Address - Street 1:16667 MURCOTT BLVD
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-1770
Practice Address - Country:US
Practice Address - Phone:561-512-8126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-15
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3106482363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner