Provider Demographics
NPI:1447038302
Name:SURRATT, MARILYN G (RN)
Entity type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:G
Last Name:SURRATT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10020 W 69TH PL
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-1519
Mailing Address - Country:US
Mailing Address - Phone:303-905-5286
Mailing Address - Fax:
Practice Address - Street 1:10020 W 69TH PL
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-1519
Practice Address - Country:US
Practice Address - Phone:303-905-5286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.0082413163WG0100X, 163WG0600X, 163WP2201X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WG0100XNursing Service ProvidersRegistered NurseGastroenterology
No163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care