Provider Demographics
NPI:1992761860
Name:FLORY, MARR-LYNN (APRN)
Entity type:Individual
Prefix:
First Name:MARR-LYNN
Middle Name:
Last Name:FLORY
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:MARR-LYNN
Other - Middle Name:
Other - Last Name:FLORY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:1100 N WOOLSEY AVE
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-1847
Mailing Address - Country:US
Mailing Address - Phone:479-444-7548
Mailing Address - Fax:
Practice Address - Street 1:1100 N WOOLSEY AVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-1847
Practice Address - Country:US
Practice Address - Phone:479-444-7548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA001430363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR154569758Medicaid
5W200Medicare ID - Type Unspecified
AR154569758Medicaid
AR5W200Medicare PIN