Provider Demographics
NPI:1285878298
Name:FOLEY, MARILYN KATHRYN
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:KATHRYN
Last Name:FOLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3707 POWERS ST
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:WI
Mailing Address - Zip Code:54476-1618
Mailing Address - Country:US
Mailing Address - Phone:715-359-9697
Mailing Address - Fax:
Practice Address - Street 1:3707 POWERS ST
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WI
Practice Address - Zip Code:54476-1618
Practice Address - Country:US
Practice Address - Phone:715-359-9697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-22
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60704-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse