Kori Marie Marks, | |
213 W Montecito Ave, Phoenix, AZ 85013-2929 | |
(623) 377-1562 | |
Not Available |
Full Name | Kori Marie Marks |
---|---|
Gender | Female |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 213 W Montecito Ave, Phoenix, Arizona |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1861267312 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | RN206978 (Arizona) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 300817 (Arizona) | Primary |
Entity Name | Greater Anesthesia Solutions |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1124430244 PECOS PAC ID: 9234357906 Enrollment ID: O20140822000525 |
Mailing Address | Practice Location Address |
---|---|
Kori Marie Marks, 213 W Montecito Ave, Phoenix, AZ 85013-2929 Ph: (623) 377-1562 | Kori Marie Marks, 213 W Montecito Ave, Phoenix, AZ 85013-2929 Ph: (623) 377-1562 |
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