Provider Demographics
NPI:1174069421
Name:MARLOWE, MCKINLEY (PA-C)
Entity type:Individual
Prefix:
First Name:MCKINLEY
Middle Name:
Last Name:MARLOWE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MCKINLEY
Other - Middle Name:
Other - Last Name:MCMULLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:550 S DUPONT PKWY APT 12T
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-5118
Mailing Address - Country:US
Mailing Address - Phone:385-224-6000
Mailing Address - Fax:385-224-6000
Practice Address - Street 1:2600 GLASGOW AVE STE 124
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-4776
Practice Address - Country:US
Practice Address - Phone:302-836-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-10
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC5-0011750363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEC5-0011750OtherPHYSICIAN ASSISTANT LICENSE