Provider Demographics
NPI:1386731107
Name:PUTTMAN, MARIAN ELIZABETH (RRT)
Entity type:Individual
Prefix:MS
First Name:MARIAN
Middle Name:ELIZABETH
Last Name:PUTTMAN
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:MARIAN
Other - Middle Name:ELIZABETH
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 168
Mailing Address - Street 2:
Mailing Address - City:LAWTEY
Mailing Address - State:FL
Mailing Address - Zip Code:32058-0168
Mailing Address - Country:US
Mailing Address - Phone:904-782-3027
Mailing Address - Fax:
Practice Address - Street 1:1601 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1135
Practice Address - Country:US
Practice Address - Phone:352-376-1611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT80452279C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredCritical Care