Provider Demographics
NPI:1154824530
Name:JARMULOWICZ, MARIE (CRNP)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:JARMULOWICZ
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 OAK FOREST RD STE D
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-4988
Mailing Address - Country:US
Mailing Address - Phone:843-815-6468
Mailing Address - Fax:843-815-6492
Practice Address - Street 1:801 PRINCETON AVE SW STE 707
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1309
Practice Address - Country:US
Practice Address - Phone:205-780-4330
Practice Address - Fax:205-780-7775
Is Sole Proprietor?:No
Enumeration Date:2018-03-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-158156363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1-158156OtherCRNP LICENSE
AL304375Medicaid