MARILYN CAROL EDGEWORTH TACOMA (NPI# 1164808382) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164808382 |
| Entity Type | Individual |
| Full Name | MARILYN CAROL EDGEWORTH TACOMA |
| Credential | RN |
| Practice Address |
1037 Morse Lee St Evanston WY 82930 |
| Practice Telephone | 3076791232 |
| Mailing Telephone | 3076791232 |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2015-08-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
14929 | WY | Nursing Service Providers |
| Street Address |
1037 MORSE LEE ST |
| City | EVANSTON |
| State | WY |
| Zip Code | 82930 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598398935 | Colby Kim Gomez | Physical Therapist | 190 Arrowhead Dr, Evanston, Wy 82930, Evanston, WY 82930 | 2020-02-13 |
| 1699159723 | Impact Physical Therapy LLC | Clinic/Center | 96 Yellow Creek Road, Evanston, WY 82930 | 2015-07-18 |
| 1578942421 | Mark Carstensen | Case Manager/Care Coordinator | 219 7th Street, Evanston, WY 82930 | 2015-05-26 |
| 1013396241 | Jennifer Carstensen | Case Manager/Care Coordinator | 325 Arrowhead Drive, Evanston, WY 82930 | 2015-05-20 |
| 1780083782 | Christa Lena Barker | Nurse Practitioner | 191 Overthrust Road, Evanston, WY 82930 | 2014-08-15 |
| 1366865339 | Don Mckay Francom | Dentist | 170 Arrowhead Dr. Suite 1, Evanston, WY 82930 | 2014-01-28 |
| 1417228370 | Premier Surgical Center, LLC | Clinic/Center | 195 Overthrust Road, Evanston, WY 82930 | 2012-01-24 |
| 1588959324 | Mejia D Williams | Social Worker | 190 Overthrust Road, Evanston, WY 82930 | 2011-06-09 |
| 1225327000 | Richard Jay Capener | Family Medicine | 196 Arrowhead Dr Ste 1, Evanston, WY 82930 | 2011-04-01 |
| 1568766889 | Tiffany Lynn Pieger | Massage Therapist | 116 10th Street, Evanston, WY 82930 | 2010-12-29 |
| Find all providers in zip 82930 | ||||
| Taxonomy Code | 163WP0808X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528077674 | Norma R. Cox | Registered Nurse | 1705 Lincoln St, Evanston, IL 60201-2342 | 2006-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396212106 | Kimberly Jo Freeman | Registered Nurse | 7508 Ventura Dr, Cheyenne, WY 82009-2044 | 2018-10-30 |
| 1679893655 | Miranda Elizabeth Blajszczak | Registered Nurse | 2340 S Coffman Ave, Casper, WY 82604-3521 | 2010-06-01 |
| 1114525524 | Jilaena Irene Freitas | Registered Nurse | 1174 N 22nd St, Laramie, WY 82072-5401 | 2020-10-16 |
| 1396354221 | Nancy Dillie | Registered Nurse | 501 S Burma Ave, Gillette, WY 82716-3426 | 2020-07-27 |
| 1497012850 | Pamela Anne Bahr | Registered Nurse | 420 Deanne Ave, Newcastle, WY 82701-2936 | 2012-04-23 |
| 1386955664 | Clarity Corporation | Registered Nurse | 311 S 2nd St, Laramie, WY 82070-3611 | 2010-07-01 |
| 1649503640 | Barbara Otto | Registered Nurse | 1841 Madora Ave, Douglas, WY 82633-3057 | 2009-09-09 |
| 1821255605 | Sharon Ann Cumbie | Registered Nurse | 1277 N 15th St, Laramie, WY 82072-2343 | 2008-05-20 |
| 1154525830 | Whitney Lane Holmen | Registered Nurse | 1263 N 15th St, Laramie, WY 82072-2343 | 2007-06-14 |
Please comment or provide details below to improve the information on MARILYN CAROL EDGEWORTH TACOMA.
| 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.