Provider Demographics
NPI:1154127249
Name:DAVIE, MARILYN MARIE (BS)
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:MARIE
Last Name:DAVIE
Suffix:
Gender:
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 MORNINGSIDE DR
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:IA
Mailing Address - Zip Code:51442-2212
Mailing Address - Country:US
Mailing Address - Phone:712-249-8670
Mailing Address - Fax:
Practice Address - Street 1:8731 GREENFIELD ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68136-1413
Practice Address - Country:US
Practice Address - Phone:712-577-0360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider