Provider Demographics
NPI:1316116692
Name:MARLOW, KJERSTEN ANNE (MPT)
Entity type:Individual
Prefix:MRS
First Name:KJERSTEN
Middle Name:ANNE
Last Name:MARLOW
Suffix:
Gender:
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4125 BEN FRANKLIN BLVD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-2167
Mailing Address - Country:US
Mailing Address - Phone:919-479-8730
Mailing Address - Fax:919-479-8782
Practice Address - Street 1:4125 BEN FRANKLIN BLVD
Practice Address - Street 2:SUITE 140
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2167
Practice Address - Country:US
Practice Address - Phone:919-479-8730
Practice Address - Fax:919-479-8782
Is Sole Proprietor?:No
Enumeration Date:2008-02-21
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9155225100000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7211453Medicaid
NC7211453Medicaid